Overall evaluation about some aspect of the world, such as people, issues, situations, or objects.
-Affective: One's feelings about the object or topic
-Behavioral: One's predisposition to act in a particular way toward the object or topic
-Cognitive: What you believe or know about the object or topic
*Attitudes are formed in seconds, based on appearance, and they affect the way we process information.
*Behavior affects Attitudes:
- Attitudes influence, but do not always lead to, behavior consistent with them. Attitudes are more likely to affect behavior if they are strong; relatively stable; directly relevant to the behavior; important; easily accessed from memory; and based on direct, rather than indirect, experience.
-Behavior can also affect attitudes. When people are asked repeatedly to assert an attitude on a given topic, it primes that attitude and makes it easier to access. As a result, they are more likely to behave in ways consistent with that attitude compared with people who do not express the same attitude. Repeatedly asserting an attitude can also make it more extreme.
-For example: You don't have an attitude about animal rights, but a friend begs you to go to a rally for animal rights. Holding up a sign at the rally changes your attitude about that situation.
Another factor in the development of liking. The more similar a stranger's attitudes are to one's own attitudes, the more likely the two people are to be attracted. The greater the similarity, the more probable that liking will endure. Similarity can involve personalities, attitudes, beliefs, values, ambitions, and abilities (e.g., level of education, religious background, ethnicity, intelligence, socioeconomic status). According to evolutionary theory, those couples among our ancestors who were more closely bonded to each other and their children were more likely to have offspring who survived. Evolutionary theorists propose that humans today are genetically predisposed not only to search for sex but also to fall in love and tend to their children. There are many reasons why certain people are viewed as potential mates whereas others are not. The characteristics associated with reproduction are likely to have been shaped by natural selection. According to evolutionary theorists:
-Men look for certain physical attributes that signal fertility and health, such as a well-proportioned body and symmetrical features. Men tend to focus on physical attractiveness.
-Women look for men who appear able to protect and nourish them and their children (as evidenced by having good earning potential). Women tend to focus on wealth and power.
-When asked to rank different characteristics in order of how important they are in ideal mates, men and women valued some characteristics (such as kindness and intelligence) similarly, but did not have identical desires at the top of their lists. It has been argued that women seek characteristics in men that would direct resources to their children, whereas men seek characteristics in women that indicate high fertility.
-As women gain economic power, their preference in mates becomes more similar to men's preference (e.g., physical attractiveness becomes more important). Perhaps women's preference for men who make good providers reflects women's historic economic dependence on men rather than a true biological preference.
-Culture plays an important role in shaping mate preferences. For example, what is considered an attractive body size (muscular or lean, thin or full-figured) or physically attractive features in general (body alterations such as tattoos, presence or absence of body hair) changes over time. It would be a serious error to assume that what people find attractive or unattractive in a potential mate can be entirely explained by analysis of what might have been useful for mating among our distant ancestors.
Regular interaction among members, some type of emotional connection among group members, a common frame of reference, and some type of interdependence (lab partners, families, student and fan groups, nations, religions). In a group, individuals may feel, think, and act less from an individual point of view and more from a group point of view.
*Norms: The rules that implicitly or explicitly govern members of a group. Shared belief systems that are enforced through the group's use of sanctions or penalties. Norms pervade everyday experience, defining the behaviors that make people good members of a family, friends, neighbors, partners, employees, and employers.
*Roles: The behaviors that members in different positions in a group are expected to perform. Groups often create different roles to fulfill different group functions. Sometimes they are filled formally (elections and appointments), whereas at other times they are filled informally (the "joker" among friends). Roles help a group delineate both responsibility within the group and responsibility to the group.
-Conducted by Phillip Zimbardo in the early 1970s to examine how roles can become reality.
-In the study, 24 male students were randomly assigned to be guards or prisoners. Student prisoners received uniforms, stayed in cells, and were referred to only by number. Guards were given uniforms, handcuffs, keys, whistles, and billy clubs. They had offices and were free to enter and leave as they pleased. Most guards wore mirrored sunglasses to prevent the prisoners from observing social cues. The student guards were not given any specific training or instructions other than to maintain "law and order" and to behave in a way that would command respect of the prisoners. The purpose of the experiment was to observe how relationships between prisoners and guards developed over time...
-Very quickly, the prisoners behaved passively. The guards began to act as if they had genuine power over the prisoners and taunted and harassed them. The prisoners later staged a rebellion, which was responded to by the guards with force.
-Zimbardo terminated the experiment early at six days rather than two weeks. He was surprised at how fast average middle-class students transformed into their assigned roles.
-Zimbardo attributes many of the atrocities at Abu Ghraib prison in Iraq in 2004 to the same situational factors that were at work in his Stanford Prison Experiment: roles, norms, and status hierarchy.
Compliance with an order from an authority figure (the tendency to do what authorities tell us to do simply because they tell us to do it).
*Stanley Milgram: Most famous study of obedience that sought to test the hypothesis that Americans would not follow orders to inflict pain on others.
-His experiment consisted of 40 men from the local community recruited to participate in a psychology experiment, supposedly on the effects of punishment on learning. The men were given the role of "teacher" in the experiment, while a confederate was given the role of "learner." The teacher was seated before an apparatus that had 30 switches ranging from 15 to 450 volts, with labels of slight shock, danger: severe shock, XXX , etc. Although the apparatus looked and sounded real, it was fake. The learner was never shocked but acted and protested as if he was.
-Psychiatrists expected that only 2% of individuals on a "pathological fringe" would deliver the maximum shock but Milgram found that 65% of the men administered all 30 levels of the shock to the point where they believed to be causing mortal injury to the learner. Even though they displayed considerable distress at shocking the learner, they still did it under direct command. 80% shocked the confederate past the point of screaming, complaining, and pleading.
-Subsequent studies (and there were many) indicated that if the experimenters did not present themselves as authority figures, the subjects were significantly less likely to give all the shocks (only 10%). The more authoritative the person who gives the order, the more likely it is to be obeyed. Also, if an accomplice defied the experimenter (a dissenter) and supported the subject's objections, obedience reduced significantly. The proximity to the authority mattered as well. When the experimenter telephoned his commands to the teacher instead of giving face-to-face instructions, obedience dropped.
-Milgram's experiments were extremely controversial, as his method involved considerable deception and emotional distress on the part of subjects. Ethics became a central concern of psychological researchers as a direct result of this study.
-Groups can either enhance or impair performance, depending on the nature of the group and the type and structure of the task.
Acting altruistically to benefit others. Includes sharing, cooperating, comforting, and helping.
A number of factors affect whether we help someone:
-Characteristics of the helper: Prosocial behavior is more likely when people have a high need for approval, have a predisposition to feeling personal and social responsibility, have an empathic concern for others or are generally high on the personality dimension agreeableness, have a sense of empathy, have a belief in a just world, have an internal locus of control, and are less concerned for their own welfare. Group identity also plays a role in prosocial behavior - we are more likely to help and cooperate with other members of our own families and groups. People may also have been reinforced for helping or punished for not helping.
-Characteristics of those being helped: People are more likely to help others that they view as similar to themselves, are friends with or like, and believe are not responsible for their predicaments or who give a socially acceptable justification for their plight.
-Characteristics of the situation: We are more likely to help when the cost of helping seems relatively low, when the "rewards" of helping are relatively high, and when there appears to be an increased cost of not helping (such as a heightened sense of shame and guilt).
Mental condition characterized by cognitive, emotional, and behavioral symptoms that create significant distress, impair work, school, family, relationships, or daily living, or lead to significant risk or harm.
-Seems easily defined but not so easy to identify. To qualify as a mental disorder, thoughts, feelings, and emotions must be persistent, harmful to the person experiencing them, and uncontrollable.
-Approximately 45-50% of people will develop some type of mental disorder during the course of their lives. After cardiovascular disease, mental disorders are the second-greatest contributor to a loss of years of healthy life and disability.
-Approximately 25% of Americans have a diagnosable psychological disorder in any given year.
-The idea of a psychological disorder is a relatively recent invention. People who act strangely or report bizarre thoughts or emotions have been known since ancient times, but their difficulties were often understood in the context of religion or the supernatural. In some cultures and religious traditions, madness is still interpreted as possession by animal spirits or demons, as enchantment by a witch or shaman, or as God's punishment for sin and wrongdoing. Prior to the 20th century, the most common treatment for mental illness was religious exorcism of some sort. In many societies, including our own, people with mental abnormalities have commonly been treated as criminals—punished, imprisoned, or put to death for their "crime" of deviating from the normal.
-Psychological disorders have been feared and ridiculed (often referred to as "madness" or "craziness"), and people with mental problems have often been victims of grave maltreatment. It is still commonly assumed that most people with mental illness will stick out due to bizarre or dangerous behavior and even physical deformity or unsightliness (ugliness).
-Most with psychological disorders are indistinguishable from others and behave quite normally. It is very likely you know multiple individuals with mental illness but have just never been informed.
-Takes into account 3 factors: Distress, Disability, and Danger.
-A behavior that is bizarre or inappropriate in one context may be entirely appropriate in another. To be considered disordered, it is not enough for a behavior to be deviant from the mainstream culture. What is considered deviant changes from generation to generation and can differ across cultures. For example, until 1973, homosexuality was officially considered a psychological disorder. Also, as health maintenance organizations (HMOs) and other types of managed care organizations try to keep costs down, they have developed their own criteria for the symptoms and disorders they will pay to have treated that may differ from scientifically accepted norms.
A classification system that describes the features used to diagnose each recognized mental disorder and indicates how the disorder can be distinguished from other, similar problems. Each disorder is named and classified as though it were a distinct illness, like a cold or the flu or a form of cancer. This guide helps mental health professionals determine the nature of a people's difficulties and how to best help them.
-System developed by clinicians using the medical model.
-The first edition of the DSM was published in 1952 and was based on psychodynamic theory. Later editions tried to avoid relying on any one theory of the causes of disorders and to base the identification of disorders on empirical research, mostly on behavioral symptoms. These later versions are largely atheoretical.
-The DSM has been criticized on a number of grounds:
-As useful as the medical model can be, it should nonetheless be viewed with some skepticism. Every action or thought suggestive of abnormality cannot be traced to an underlying disease. Some of the most successful treatments for abnormal behavior or thought focus on simply eliminating the behavior or thought- no effort is made to treat the root "syndrome" as with medical diseases. PSYCHOLOGY IS NOT JUST BIOLOGY.
**It does not provide a discrete boundary separating abnormality from normality. Some of the disorders are not clearly distinct from one another, although they are often presented as if they were. Levels of agreement among different diagnosticians can vary depending on the diagnostic category.
-The DSM offers many benefits as well:
-The alternatives to the medical model are worse. Previous views of disorders have suggested that abnormal minds must be spiritually condemned or physically punished. The medical model offers a humane alternative: Because psychological disorders are seen as medical problems, people who are suffering can be offered care and treatment and viewed as ill rather than evil or dangerous.
-It is theoretically neutral—that is, it makes no assumptions about why disorders arise or the best way to treat them.
-It strives to create standards that can be used to ensure reliability in diagnosis. The DMS-IV is the predominant means used to categorize psychological disorders in the United States.
-Determining the degree to which a person has a mental disorder is always difficult: Mental disorder exists along a continuum from normal to abnormal without a bright line of separation. Difficulty in functioning can occur on a variety of levels (biological, cognitive, behavioral, interpersonal/social).
-There are now 17 main categories of mental disorders in DSM-IV-TR. We will only review disorders from 5 of the classes.
-Psychiatric labels can have negative consequences despite mental health workers' intensions to use them solely for diagnosis (to improve communication). The labels can invoke negative stereotypes, which can create new problems.
-The stigma associated with mental disorders may help explain why nearly 70% of people with diagnosable mental disorders do not seek treatment.
-Many people believe that a mental disorder is a sign of personal weakness or a consequence of wrongdoing, so it can feel shameful to seek help for or even discuss the problem.
-Others falsely believe that psychiatric patients are dangerous. 96% of violent crime is committed by individuals with no mental health history. The biggest predictors of violence are gender (being male) and substance intoxication (primarily alcohol).
-Many are overly alert or even avoidant in the presence of individuals with mental disorders. Those with disorders become aware of this and can feel quite uncomfortable or may start avoiding social contact, both of which can cause problems themselves.
-Unfortunately, educating people about mental disorders does not dispel the stigma. Expectations created by psychiatric labels can even compromise the judgment of mental health professionals.
-Psychologist David Rosenhan led a social experiment in which several individuals reported to different mental hospitals complaining of "hearing voices". All were admitted to a hospital as a result of this fake symptom, and each then promptly reported that the symptom had ceased. Fellow patients frequently identified them as normal, but hospital staff did not recognize this. It took between 9-62 days for the false patients to secure their release, and they were all labeled schizophrenic upon release.
-Sometimes the labeled person comes to view the self negatively - not just as mentally disordered but also as hopeless or worthless. People who think poorly of themselves can develop attitudes of defeat and as a result may fail to work toward their own recovery.
-Throughout much of human history, etiological explanations for abnormal behavior were driven by cultural preferences and biases. For much of the last 100 years, explanations of disorders were driven by specific psychological theories (E.g., Psychodynamic, Humanistic, Behavioral, etc.)
-Culture can influence the conception of psychological disorders. The principal categories of psychological disturbance (schizophrenia, depression, bipolar) are identifiable in all cultures, but milder disorders may go unrecognized in some societies. There are no universal standards of normality and abnormality.
-Culture-bound disorders illustrate the diversity of abnormal behavior around the world, as well as cultural influence. Some abnormal syndromes are found in only a few cultural groups:
*Koro: An obsessive fear that one's penis will withdraw into one's abdomen and possibly cause death, seen only in Malaysia and other regions of southern Asia.
*Windigo: Involves intense craving for human flesh and fear that one will turn into a cannibal (a from of spirit possession), seen only among Algonquin Indian cultures (ancient Indians of Northeast United States).
*Mal de Ojo: (Evil eye) is a disorder resulting from looking at a child with envy in Mediterranean cultures (Italy, Spain) and involves a variety of symptoms in children, such as fitful sleep, crying without cause, diarrhea, vomiting, and fever.
*Taijin Kyofusho: A form of social anxiety common in Japan involving a fear of offending or embarrassing others with one's odor, eye contact, or appearance.
*Anorexia Nervosa: An eating disorder characterized by intentional self-starvation possibly up to death as a result of an intense fear of gaining weight, until recently seen only in affluent Western cultures, but is "catching" as our cultural ideals of beauty spread.
-Focus on a specific object or non-social situation. The fear may occur in the presence of the stimulus or in anticipation of it, despite an intellectual recognition that the fear is excessive or unreasonable. By avoiding the object or situation, the sufferer avoids the fear, anxiety, or panic that it might elicit.
-There are five subtypes of specific phobias: animal fears (snakes, spiders, dogs), blood-injection-injury fears (fainting at the sight of blood), natural environment fears (storms, heights, the ocean), situation fears (enclosed spaces, flying), and miscellaneous fears cued by stimuli not already mentioned (choking, catching a disease).
-Phobias can be explained by looking at the different perspectives. Phobias have a genetic component and often run in families. Humans seem biologically prepared to develop phobias about certain stimuli and not others, so there appears to be an evolutionary component. Specific phobias may reflect a genetic predisposition to fear naturally occurring events or objects that were a danger to the human species.
-Classical and operant conditioning play a role in the development of a specific phobia.
-Phobias can be developed through classical conditioning and maintained through operant conditioning.
-Observational learning from the behavior of other people who fear particular objects or situations can lead to the development of a phobia by indicating what should be feared.
-A person who endures frequent, unexpected panic attacks or fears additional panic attacks, and therefore changes aspects of his or her life in hopes of avoiding them.
*Panic Attacks: Episodes of intense fear, anxiety, or discomfort accompanied by physical and psychological symptoms such as heart palpitations, breathing difficulties, chest pain, nausea, sweating, dizziness, fear of going crazy or doing something uncontrollable, fear of impending doom, and a sense of unreality. Symptoms of panic attacks reach their peak within a few minutes of the beginning of an attack. An attack can last from minutes to hours, but typically becomes manageable within 10 minutes. Often attacks are not associated with a specific situation, objects, or threats—that is, they may occur randomly without warning or reason.
People with panic disorder worry about having more attacks and may change their behavior to attempt to avoid or minimize attacks.
Panic attacks may lead to agoraphobia.
*Agoraphobia: ("Fear of the marketplace") A condition in which people fear or avoid public or open places that might be difficult to leave should panic symptoms occur. People suffering from agoraphobia may completely avoid leaving home or will do so only with a close friend or relative.
*Orexins: Chemical messengers in the brain that play a role in wakefulness and vigilance. Disturbances involving these orexins may lead to panic attacks. Those who develop panic disorder have larger quantities of these.
*Anxiety Sensitivity: The belief that autonomic arousal (body arousal) can have harmful consequences. People with this belief are at higher risk of experiencing spontaneous panic attacks. The misinterpretation of the causes of physiological events (e.g., increased heart rate) may increase sympathetic nervous system activity and lead to panic.
-Marked by the presence of obsessions either alone or in combination with compulsions.
-Approximately 2-3 percent of Americans suffer from this at some point in their lives.
*Obsessions: Recurrent and persistent thoughts, impulses, or images that feel intrusive and inappropriate and that are difficult to suppress or ignore. Obsessions are more than excessive worries about real problems. They may cause significant anxiety and distress. Common obsessions involve thoughts of contamination, repeated doubts, the need to have things in a certain order, and aggressive or horrific impulses.
*Compulsions: Repetitive behaviors or mental acts that some individuals feel driven to perform in response to an obsession. Some examples of compulsive behaviors are washing (in response to thoughts of contamination), checking, ordering, and counting.
-Anxiety plays a role in this disorder because the obsessive thoughts produce anxiety, and the compulsive behaviors are performed to reduce it. The obsessions and compulsions of OCD are intense, frequent, and experienced as irrational and excessive. Attempts to cope with the obsessive thoughts by trying to suppress or ignore them are of little or no benefit. Some people with OCD believe that a dreaded event will occur if they do not perform their ritual. These compulsions are unrealistically connected to what they are trying to ward off, at least not in the frequency and duration with which the compulsion occurs.
-Twin studies suggest a strong genetic component to OCD, with concordance rates of 63-87% for identical twins with this disorder. So if one identical twin has the disorder, the concordance rate provides the likelihood that the other twin will also be diagnosed.
-An anxiety disorder that occurs as a consequence of a traumatic event such as war, physical or sexual abuse, terrorism, or natural disasters. A diagnosis of PTSD is made when three conditions are met:
-The person experiences or witnesses an event that involves actual or threatened serious injury or death.
-The traumatized person responds to the situation with fear and helplessness.
-The traumatized individual experiences three sets of symptoms, which do not always appear immediately after the traumatic event but can persist for months or even years: persistent re-experiencing of the traumatic event, persistent avoidance of anything associated with the trauma and general emotional numbing, and heightened arousal.
-Persistent re-experiencing of the traumatic event can take the form of intrusive, unwanted, and distressing recollections, dreams, or nightmares of the event, or may involve flashbacks that can include illusions, hallucinations, and a sense of reliving the experience.
-Heightened arousal may cause people with PTSD to startle easily, have difficulty sleeping, or be in a constant state of hypervigilance.
-The majority of people who experience trauma do not go on to experience PTSD. The type of trauma makes a difference in the outcome.
-Some people may be biologically at risk for developing PTSD, perhaps because of a genetic predisposition or some trauma experienced early in childhood that enhances the fight-or-flight response.
-A history of social withdrawal, depression, or not being able to control stressors increases the risk of developing PTSD. The perception that your life is at risk during the traumatic event or that you have no control over it can facilitate development of PTSD (regardless of the actual level of threat).
-Support from friends, family, or counselors immediately after a trauma can decrease the likelihood that PTSD will develop. Those with little social support are more likely to develop the disorder.
-(MDD) is characterized by at least two weeks of depressed mood or loss of interest in nearly all activities, along with at least five symptoms of depression (loss of pleasure in normal activities- called anhedonia, sleep or eating disturbances, loss of energy, restlessness or sluggishness, feelings of worthlessness and guilt, thoughts of suicide). It is also called unipolar mood disorder as it involves only one emotional extreme.
-Depression is much more than normal sadness. The combined symptoms create dysfunction in normal life, they are chronic, and they fall outside the range of socially or culturally expected responses.
-Depression is also different from the sorrow and grief that accompany the death of a loved one- a normal, possibly adaptive response to a tragic situation.
-It is estimated that one in five people in the United States will experience depression in their lifetime. MDD is found among all cultural, ethnic, and economic groups. In the United States, women are diagnosed two to three times more frequently than men. The overall prevalence is increasing in the United States.
-The frequency of depressive episodes varies. Approximately 1/3 of affected people experience only one episode. Other people experience recurrent episodes that are either frequent or separated by years. Some people have more chronic depression.
-Not all cultures share exactly the same symptom list. Many cultures experiences more physical symptoms. Latin and Mediterranean cultures who are depressed complain of headache and fatigue. In Asian cultures, people with major depression are likely to report weakness, tiredness, or a sense of "imbalance" or other bodily symptoms.
-Many suicide attempts are motivated by the sense of hopelessness that is often a part of depression. It is estimated that more than 34,000 depressed people commit suicide every year in the United States, making it the 11th leading cause of death in the country. Among college and graduate students in the 18-30 year age range, it is the second leading cause of death. There are many misconceptions (myths) about suicide:
-If you talk about suicide, you won't really do it.
-People who attempt suicide are "crazy."
-Someone who is determined to commit suicide can't be stopped.
-People who commit suicide weren't willing to seek help.
-Talking about suicide could give someone the idea, so you shouldn't talk or ask about it.
NONE OF THESE ARE TRUE.
A mood disorder marked by one or more episodes of mania, or the less intense hypomania, often alternating between periods of depression.
Approximately one percent of Americans have bipolar disorder and it is equally common in men and women.
*Manic Episode (mania): A period of at least a week during which an abnormally elevated, expansive, or irritable mood persists. It is not just having an "up" day. The sufferer may be euphoric and enthusiastic about everything. Symptoms include grandiosity, decreased need for sleep, talkativeness, racing thoughts, distractibility, impulsivity, reckless behavior, violence, and even psychotic symptoms. Although mania can increase productive behavior, a crucial diagnostic criterion is an "increased tendency to engage in pleasurable activities that have a high potential for painful consequences," including substance abuse, gambling, irresponsible sexual activity, and shopping. This aspect of destructive and impulsive pleasure-seeking distinguishes manic episodes from normal periods of positive mood and high energy. People experiencing hypomania have less severe symptoms of mania, and their symptoms are less likely to interfere with social functioning.
*Depressed Phases: Manic or hypomanic episodes are often preceded or followed by episodes of depression. The cycling of the mood usually takes place over a number of years, although some people may experience rapid cycling with four or more mood shifts in a year.
-Prognosis for bipolar disorder is generally poor compared to unipolar mood disorders.
-Mood disorders tend to run in families, so genes play a role in predisposing people to depression and bipolar illness. Evidence supports an underlying genetic relationship between bipolar and depressive mood disorders. Concordance rates in identical twins for major depression run about 30-40%. If an identical twin has bipolar disorder, the co-twin has an 85% percent chance of developing bipolar disorder.
****Bipolar disorder has the strongest genetic component of all disorders.
-Some neurotransmitters do not function normally in mood disordered individuals, particularly serotonin. But it's also believed that neurotransmitter interactions are impaired in the depressed and bipolar.
-A psychotic disorder that profoundly alters affect, behavior, and cognition, particularly the pattern or form of thought.
-The word schizophrenia is derived from two Greek words: schizo, meaning "to split", and phren, meaning "mind". However, this disorder should NEVER be confused with Multiple Personality Disorder (MPD).
-Symptoms of schizophrenia are usually classified into two groups: positive and negative. Not all patients experience all symptoms. A diagnosis can be based on two or more symptoms experienced strongly most of the time for at least one month, during a period of at least 6 months in which milder symptoms are present. Clusters of symptoms are the basis for recognized subtypes of schizophrenia.
*Positive Symptoms: Involve an excess or distortion of normal functions. They are called positive not because they indicate something desirable, but rather because they mark the presence of certain unusual behaviors. Positive symptoms include:
*Hallucinations: Mental images in any sensory modality (but mostly visual or auditory) that are so vivid that they seem real. Hallucinations are false perceptions that are often repetitive and negative in nature.
*Delusions: Entrenched and unshakable false beliefs that are often bizarre (of persecution, grandeur, reference, or control). For example, the belief that a person's thoughts are being controlled by aliens is a delusion. Delusions can be quite complex. Such beliefs however, even if false, should not be considered abnormal if they are an accepted part of the culture. For example, in some religious groups, it is not considered abnormal to hear voices, especially the voice of God.
*Disorganized Speech: A severe disruption of verbal communication in which ideas shift rapidly and incoherently from one to another unrelated topic. this reflects difficulties in organizing thoughts and focusing attention. Responses to questions are often irrelevant, ideas are loosely associated, and words are used in peculiar ways ("word salad").
*Disordered Behavior: Behavior that is inappropriate for the situation or ineffective in attaining goals, often with specific motor disturbances. A patient might exhibit constant childlike silliness, improper sexual behavior, disheveled appearance, or loud unpredictable shouting or swearing. Specific motor disturbances might include strange movements, rigid posturing, odd mannerisms, bizarre grimacing, or hyperactivity. It also may involve a complete lack of hygiene.
*Negative Symptoms: Involve a dimunition or loss of normal functions. These symptoms refer to things missing in people with schizophrenia, in contrast to the positive symptoms that appear more in people with schizophrenia than in other people. Negative symptoms include:
*Flat Affect: A general failure to express or respond to emotion.
*Alogia: ("Poverty of Speech") Brief, slow, empty replies to questions.
*Avolition: An inability to initiate goal-directed behavior. An apparent complete lack of motivation.
-Approximately 1 percent of people worldwide will develop schizophrenia in their lifetimes. The disease is equally prevalent in men and women. The average age of onset of schizophrenia is the 20s, although in some people (especially women) onset does not come until later in life. In other cases, the disorder begins in the early teen years- prognosis is poor in such cases. Despite its relatively low frequency, schizophrenia is the primary diagnosis for nearly 40% of all admissions to state and county mental hospitals; it is the second most frequent diagnosis for inpatient psychiatric admission at other types of institutions.
-Symptoms often occur gradually. The prodromal phase is characterized by slow deterioration in functioning, including withdrawal from other people, poor hygiene, and outbursts of anger. Eventually, the symptoms reach an active phase, in which full-blown positive and negative symptoms arise. Positive symptoms are usually more responsive than negative symptoms to antipsychotic medication (the primary mode of treatment).
-Twin, family, and adoption studies point to the strong influence of genetic factors in the development of schizophrenia. Having relatives with schizophrenia increases the risk of developing schizophrenia. The closer the affected relative, the greater the risk. Concordance rates between identical twins run about 50%. Only OCD and Bipolar Disorder have a stronger genetic component. Studies of adopted children whose biological parents have schizophrenia indicate that these children are still at a greater risk for the disorder despite being raised by healthy parents. Interestingly, children adopted by a parent with schizophrenia, but whose biological parents do not have the disorder, exhibit NO increased rate of the disorder despite their abnormal upbringing.
-Evidence from autopsies and brain-scanning studies suggests that schizophrenia may involve abnormalities in brain structures. Someone with schizophrenia is more likely than others to have enlarged ventricles (cavities in the center of the brain filled with cerebrospinal fluid). Enlarged ventricles translate into a reduction in the size of other brain areas (neural degeneration), essentially a loss of brain tissue. Normal brain development might potentially go awry during gestation- possibilities include maternal malnourishment during pregnancy, maternal illness, maternal stress and higher levels of cortisol, and prenatal or birth-related complications that lead to oxygen deprivation.
-Children at risk for schizophrenia are more reactive to stress and have higher baseline levels of cortisol (the stress-related hormone), which are associated with more severe symptoms.
-High levels of stress-related hormones are thought to affect the activity of the neurotransmitter dopamine. Abnormalities in the functioning of this neurotransmitter have been implicated in schizophrenia.
-People with schizophrenia may have problems processing and responding to sensory stimuli, which may lead to unusual sensory experiences. These individuals may feel bombarded by the myriad stimuli and have trouble focusing and making sense of them.
People with schizophrenia are likely to have difficulties with interpreting and using information in various contexts. They may not be able to determine the importance or relevance of new information or stimuli or to distinguish relevant from irrelevant stimuli. They may have difficulty understanding social cues and, therefore, respond inappropriately. They may not realize that they are having problems (lack of insight).
-Stressful life events often trigger positive symptoms of schizophrenia.
-Most individuals with schizophrenia in recovery go to live with their families. The way a family expresses emotions can affect the likelihood of a recurrence of acute schizophrenia symptoms, although it does not cause schizophrenia.
*High Expressed Emotion: An emotional style in which family members are critical, hostile, and overinvolved. Families with this emotional style are more likely to lead to relapse of symptoms for those in recovery.
A set of relatively stable personality traits that are inflexible and maladaptive, causing distress or difficulty with daily functioning in school, work, social life, or relationships. They involve impairments in identity and in the establishment of empathy or intimacy. A personality disorder may occur alone or may be accompanied by an Axis I disorder. Whereas Axis I symptoms feel as if they are inflicted from the outside, the maladaptive traits of Axis II are often experienced as parts of the person's personality.
*Antisocial Personality Disorder: (ASPD) The most studied personality disorder that is evidenced by a long-standing pattern of disregard for others to the point of violating their rights. Symptoms include: superficial charm; egocentrism; impulsive, reckless, and deceitful behavior without regard for others' safety; a tendency to blame others for any adversity that comes the person's way; and a lack of conscience, empathy, and remorse.
People with this disorder can talk a good line and know how to manipulate others, but don't know or care how another person feels. Often called "psychopaths".
ASPD occurs three times more frequently in men than women. Only one to two percent of Americans are diagnosed with this disorder, although 60 percent of male prisoners are estimated to have it.
Many people diagnosed with ASPD also abuse alcohol and drugs.
ASPD is partly genetic- runs strongly in male family lines, even if the children are put up for adoption. The genetic inheritance likely involves an under-responsive nervous system with some brain abnormalities involving the amygdala. The amygdala participates in recognition of fear and other negative emotions in others. It is also involved in learning through fear. It is underactive in individuals with ASPD. These individuals do not learn from punishment or respond to fear the same as others. Additionally, they seem to require a higher level of cortical stimulation than "normal" activities and social interactions provide for enjoyment and arousal. This leads to increased risk-taking behaviors during development.
It also appears that being raised in "antisocial" family and social environments are risk factors for ASPD. Children who often experienced or witnessed abuse, deviant behavior, or a lack of concern for others by peers, parents, or others are more likely to develop these traits. This typically occurs as a result of insecure attachments (or no attachments formed whatsoever). The behaviors of models who lack basic regard for others may later be imitated. This exposure likely interacts with a genetic predisposition as plenty of healthy well-adjusted adults had a "bad childhood".
*Borderline Personality Disorder: Characterized by instability in interpersonal relationships, self-image, and emotion. The term "borderline" in BPD reflects an original conceptualization of this disorder as lying on the border of anxiety and psychosis. Individuals with BPD tend to be intensely preoccupied with abandonment. Self-destructive impulses and behaviors are also a common symptom. The disorder is more frequently diagnosed in women. Studies find that BPD runs in families, which may suggest a genetic vulnerability. However, as many as 70% of individuals diagnosed with BPD have a history of abandonment, neglect, and/or physical or sexual abuse.