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Chapter 14

STUDY
PLAY
Rates and symptoms of psychological disorders vary by culture, but no known society is free of two terrible ones:
depression and schizophrenia
Psychological disorder
deviant, distressful, and dysfunctional behavior patterns
Attention-deficit hyperactivity disorder (ADHD):
def

rate of diagnosis

rate in boys

possible causes

treatments

one theory about brain maturation
a psychological disorder marked by the appearance by age 7 of one or more of the three key symptoms: extreme inattention, hyperactivity, and impulsivity


4% of children who display at least one of the symptoms are diagnosed with ADHD

2-3 times more often diagnosed in boys


Often coexists with a learning disorder or with defiant and temper-prone behavior; also heritable

Adderall and Ritalin (nonaddictive)
Psychological therapies - like making new habits

children with ADHD's brain maturation is normal but lagged by about three years, with delayed thinning, or pruning, of the frontal cerebral cortex.
Philippe Pinel
Philippe Pinel of France insisted that madness was not a demon possession but a sickness of the mind caused by sever stresses and inhumane conditions.
medical model
the concept that diseases, in this case psychological disorders, have physical causes that can be diagnosed, treated, and, in most cases, cured, often through treatment in a hospital
Mental health movement
a mental illness (also called a psychopathology) needs to be diagnosed on the basis of its symptoms and cured through therapy, which may include treatment in a psychiatric hospital
psychologists today look to which model?
Mental health movemen
Psychological disorders are influenced by:(4)
Genetic factors
Physiological states
Physiological dynamics - how your physiology works with other components of your physiology
Social and cultural circumstances
susto
a Latin American disorder marked by severe anxiety, restlessness, and a fear of black magic
Taijin-kyofusho
in Japan, a social anxiety about one's appearance combined with a readiness to blush and a fear of eye contact
In psychiatry and psychology, diagnostic classification aims not only to describe a disorder but also to: (3)
predict its future course,

imply appropriate treatment,

and stimulate research into its causes
DSM-IV-TR:

what is it?

developed with?

organized how?

diagnoses how many syndromes?
the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Forth Editions, with an updated "text revision"; a widely used system for classifying psychological disorders

Developed in coordination with the tenth edition of the WHO's International Classification of Diseases (ICD-10), which covers both medical and psychological disorders

Organized into a multiaxial system

Offers a diagnostic process and 16 clinical syndromes
Five DSM-IV axes
Axis 1: clinical disorders
Dementia, schizophrenia, eating and sleeping disorders

Axis 2: personality disorders and mental retardation
Antisocial, paranoid, narcissistic personality disorders

Axis 3: general medical conditions
Diseases of the nervous system

Axis 4: psychosocial and environmental problems
Social environment, occupational, educational

Axis 5: global assessment and functioning
Companion catalog of human strengths to the DSM-IV-TR
the thinking-feeling-action tendencies that contribute to the good life, for self and others
the human strengths manual assesses __ (#) clusters of __(#) strengths
6

24
6 Strengths (Just to become familiar with them):
Wisdom and knowledge

Courage

Love


Justice


Temperance

Transcendence
...
David Rosenhan conducted an experiment that showed what?
biasing power of labels
Legal sanity defense was created in 1843 in the case in which:
a deluded Scotsman tried to kill the Prime Minister.
anxiety disorders
psychological disorders characterized by distressing, persistent anxiety or maladaptive behaviors that reduce anxiety
Generalize anxiety disorder-
a person is unexplainably and continually tense and uneasy
Panic disorder- a person experiences sudden episodes of intense dread
phobias
a person feels irrationally and intensely afraid of a specific object or situation
OCD
a person is troubled by repetitive thoughts or actions
PTSD
a person has lingering memories, nightmares, and other symptoms for weeks after a severely threatening, uncontrollable event
Generalized anxiety disorder-

what is it?

what fraction are women?

worst characteristic
an anxiety disorder in which a person is continually tense, apprehensive, and in a state of autonomic nervous system arousal

2/3


cannot identify, and therefore cannot deal with or avoid, its cause
panic disorder:

def

how common is it?

can be misperceived as what?
an anxiety disorder marked by unpredictable minutes-long episodes of intense dread in which a person experiences terror and accompanying chest pain, choking, or other frightening sensations

1 in 75


May be misperceived as a heart attack or serious physical ailment
phobia
an anxiety disorder marked by a persistent, irrational fear and avoidance of a specific object or situation
social phobia
shyness taken to an extreme, an intense fear of being scrutinized by others. Sweat, tremble, or have diarrhea when in the spotlight
agoraphobia
fear or avoidance of situations in which escape might be difficult or unavailable when panic strikes
OCD
an anxiety disorder characterized by unwanted repetitive thoughts (obsessions) and/or actions (compulsions)
OCD is more common among:
among teens and young adults.
PTSD
an anxiety disorder characterized by haunting memories, nightmares, social withdrawal, jumpy anxiety, and/or insomnia that lingers for four weeks or more after a traumatic experience (shellshock and battle fatigue)
The greater one's emotional distress during a trauma:
the higher the risk for post-traumatic symptoms
A sensitive ____ system seems to increase vulnerability, by flooding the body with stress hormones again and again as images of the traumatic experience erupt into consciousness
limbic
Those who do not develop PTSD after trauma have____

___ of adults experience trauma at least once, but only 1 in __ women and 1 in __ men develop PTSD
survivor resiliency

1/2

10

20
Post-traumatic growth-
positive psychological changes as a result of struggling wight extremely challenging circumstances and life crises
Two contemporary perspectives of anxiety
learning and biological
58% of those with social phobia experienced their disorder_____
after a traumatic event
Two specific learning processes can contribute to such anxiety:
stimulus generalization

reinforcement
stimulus generalization
occurs, for example, when a person attacked by a fierce dog later develops a fear of all dogs
reinforcement
helps maintain our phobias and compulsions after they arise
Avoiding or escaping the fear situations reduces anxiety, thus ____
reinforcing the phobic behavior
Genes influence disorders by regulating ______
neurotransmitters
Some studies point to an anxiety gene that affects brain levels of _____, a neurotransmitter that influences sleep and mood.


Other studies implicate genes the regulate ____. With too much ____, the brain's alarm centers become overreactive
serotonin

glutamate
Anxiety disorders are manifested biologically as an overarousal of brain areas involved in (2)
impulse control and habitual behaviors
The _____, a brain region that monitors our action and checks for errors, seems especially likely to be hyperactive in those with OCD
anterior cingulate cortex
Fear-learning experiences that traumatize the brain can also create fear circuits in the ____
amygdala
Somatoform disorder
psychological disorder in which the symptoms take a somatic (bodily) form without apparent physical cause
Conversion disorder
a rare somatoform disorder in which a person experiences very specific genuine physical symptoms for which no physiological basis can be found (Freud). Person will be strangely indifferent to the problem
Hypochondriasis
a somatoform disorder in which a person interprets norma physical sensations as symptoms of a disease
Dissociative disorders
disorders in which conscious awareness becomes separated (dissociated) from previous memories, thoughts, and feelings (assumes repressed memories)
Dissociative identity disorder (DID)
a rare dissociative disorder in which a person exhibits two or more distinct and alternating personalities. Formerly called multiple personality disorder

Typically, the original
personality denies the awareness of the other(s)
DID is very localized in ___ and ___
space and time

(Almost nonexistent in Japan and India. )
mood disorders
psychological disorders characterized by emotional extremes.
mood disorders come in two principle forms:
1. Major depressive disorder
2.Bipolar disorder
Major Depressive Disorder's nickname
"common cold" of psychological disorders
_____ is the leading cause of disability worldwide
depression
About 1 in __ people diagnosed with depression is simply struggling with the normal emotional impact of a significant loss
4
Major depressive disorder
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
mania
a mood disorder marked by a hyperactive, wildly optimistic stage
bipolar disorder
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)
there is a __ fold increase in bipolar diagnoses in those under 19
40
what fraction of bipolar diagnoses are boys?

BUT....
2/3

it affects men and women equally
describe manic phase
Overtalkative
Overeactive
Elated
Speech is loud, flighty, and hard to interrupt
Advice is irritating
Poor judgment
Nearly half the time, people with mood disorders also exhibit:
symptoms of another disorder, such as anxiety or substance abuse
Compared with men, women are nearly_____ as vulnerable to major depression.
twice
__% of those who recover from depression will suffer another episode within two years
50
Heritability of major depression is ____%
35-40
Linkage analysis-
teases out genes that cause depression. These studies show that depression is a complex condition
____ lobe is likely to be inactive in depressive states
left frontal
At least two neurotransmitters play a role in mood disorders:
1. Norepinephrine - increases arousal and boosts mood. Scarce in depression and overabundant in mania

2. Serotonin- scarce during depression. Stressed individuals are much more likely to be depressed if they carry a variation of the serotonin-controlling gene
Repetitive physical exercise boosts ____
serotonin
Boosting serotonin stimulates _____neuron growth and could thus promote recovery from depression
hippocampus
Seligman contends that depression is common among young Westerners because:
the rise of individualism and the decline of commitment to religion and family have forced young people to take personal responsibility for failure or rejection
rate of schizophrenia
1 in 100
Schizophrenia
a group of severe disorders characterized by disorganized and delusional thinking, disturbed perceptions, and inappropriate emotions and actions. "split brain"
delusions
false beliefs, often of persecution or grandeur, that may accompany psychotic disorders
word salad
jumbled ideas in sentences
Disorganized thoughts may result from a breakdown in :
selective attention
hallucinations
sensory experiences without sensory stimulation
catatonia
remain motionless for hours and then become agitated
Schizophrenia typically strikes as :
young people are maturing into adulthood
___ tend to be struck earlier, more severely, and slightly more often
men
schizophrenia can appear ___ or ____
suddenly or gradually
Positive symptoms
hallucinations, talk in disorganized or delusional ways, and exhibit inappropriate laughter, tears, or rage
Negative symptoms
toneless voices, expressionless faces, or mute and rigid bodies
One rule holds true: when schizophrenia is a slow-developing process (called chronic, or process, schizophrenia), recovery is ____
doubtful
Men's schizophrenia develops on average ____ years sooner and more often exhibits negative symptoms and chronic schizophrenia
4
_____ schizophrenia is developed rapidly and more likely to be recovered from and be treated with drug therapy
acute (reactive)
Schizophrenics have a six-fold excess for the:
D4 dominion receptor
Dopamine-blocking drugs have no effect on ____ symptoms. Drugs that interfere with _____ receptors can produce schizophrenialike negative symptoms.
negative

glutamate
some with schizophrenia have low brain activity in ____
frontal lobes
When hallucinating, there is vigorous activity in the ____, a structure deep in the brain that filters incoming sensory signals and transmits them to the cortex.
thalamus
People with paranoia have increased activity in the _____
amygdala, a fear-processing center
those with schizophrenia have shrinkage in:
cortex and thalamus
Two known risks factors for schizophrenia are:
low birth weight and oxygen deprivation during delivery.
another possible risk for schizophrenia:

it must be in:
a midpregnancy viral infection that impairs fetal brain development

second trimester
Identical twins have a 1 in _ chance of getting schizophrenia if other twin has it
1 in _ if sibling or parent has it
_ in 10 if placenta is shared
2

10

6
Those who develop schizophrenia were found to have some tendency to ___(2) before the onset of the disorder.
socially withdraw and behave oddly
personality disorders
psychological disorders characterized by inflexible and enduring behavior patterns that impair social functioning
Avoidant personality disorder
expresses anxiety, such as a fearful sensitivity to rejection
Schizoid personality disorder
expresses eccentric behaviors, such as emotionless disengagement
Histrionic personality disorder
exhibits dramatic or impulsive behaviors
Narcissistic personality disorder
self-focused and self-inflating
Antisocial personality disorder
psychological disorders characterized by inflexible and enduring behavior patterns that impair social functioning
Most troubling and heavily researched personality disorder
Antisocial personality disorder
A person (formerly called a sociopath or psychopath) is typically a male whose lack of conscience becomes plan before age 15, as he beings in lie, steal, fight, or display unrestrained sexual behavior.

this describes someone with what?
Antisocial personality disorder
about __(fraction) of antisocial children become antisocial adults
1/2
Violent repeat offenders have ___% less frontal lobe tissue than normal
11
Two combined factors predict antisocial behavior:
childhood maltreatment and a genet hat alters neurotransmitter balance
__% of Americans have a mental disorder any given year
26
Incidence of serious psychological disorder is ___ for those below poverty line
double
Over ___% experience first symptoms by 24.
75
The symptoms of antisocial personality disorder and of phobias are among the earliest to appear, at a median age of __ and __, respectively.
8 and 10
ymptoms of alcohol dependency, obsessive-compulsive disorder, bipolar disorder, and schizophrenia have a median age of __
20
Major depression has a median age of __
25