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Psychological Disorders

§ Behavior patterns or mental processes that:– cause serious personal suffering or– interfere with a person’s ability to

cope with daily life

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What Is Abnormality?

§ No biological test § Judgment call§ Heavily influenced by

– Social norms– Context

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What Is Abnormality?

ABNORMAL NORMAL

most behavior

Most of the disorders in this unit involve symptoms that everyone experiences!

Abnormality comes down to time, intensity, impact

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What Is Abnormality?

Current consensus…

All must be considered!

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What Is Abnormality?§ Deviant

– Statistically uncommon

Wearing beekeeper’s outfit

…in the shower.

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What Is Abnormality?

§ Dysfunctional– Interferes with day-to-day life

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What Is Abnormality?§ Dysfunctional

You get anxious around people

you skip a lot of parties

you haven’t left your house in two years

VS

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Defining Abnormal Behavior

§ Distressing (to self or others)– Negative emotions

q Crying a lot whenyou’re sad► …which is

every day for months.

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Lifetime Mental Disorder Rate, 18+46%

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2

2014 Mental Disorder Rate, 18+18%

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2014 Serious Mental Disorder Rate, 18+ = 4%

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12 Month Mental Disorder Ratesby Type, 18+ (2012)

0%

10%

20%

Anxiety Mood Schizophrenia

18%

9.5%

1%

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Facts About Mental Illness

§ Average age at onset = 14§ Most people recover§ Few are violent§ Most suffer quietly and privately

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Diagnosing Mental Disorders

§ Diagnostic and Statistical Manual of Mental Disorders (DSM)

q Current version: DSM-5q Lists of symptomsq 19 categories

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Anxiety Disorders

§ What is anxiety?– Fear of future danger or misfortune,

accompanied by emotional and/or physical tension

§ May be related to specific object or situation

§ About 75% before age 22 (avg = 11)

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Generalized Anxiety Disorder

§ 3% of adults§ Excessive anxiety and worry on most

days for at least 6 months, about a number of events or activities

§ No specific trigger§ Anxiety difficult to control

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Panic Disorder§ 3% of population§ Recurrent unexpected panic attacks

– Intense fear or discomfort– Many physical and psychological

symptoms– No obvious trigger for attacks

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Panic Disorder

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3

§ 9% of population§ Excessive, irrational fear & avoidance of

specific object or situation§ Usually begins in childhood

Specific Phobia

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§ Most common phobia?

Specific Phobia

animals & insectszoophobia

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§ Other common phobias

Specific Phobia

acrophobiahemophobia

heightsblood

closed-in placesclaustrophobia

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Social Anxiety Disorder§ 7% of population§ Fear or anxiety about one or more social

situations in which individual is exposed to possible scrutiny of others

§ Person fears he/she will act in way that will be negatively judged

§ Possible situations to avoid:– Public speaking– Eating in public

– Meeting strangers– Talking to people

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Obsessive-Compulsive Disorder§ 1% of population§ Either obsessions, compulsions, or both§ Obsession

– Recurrent unwanted thoughts that cause anxiety

§ Compulsion– Repetitive behaviors or mental acts

that person feels they must do– Aimed at reducing anxiety

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The OCD Cycle

Obsession

Anxiety

Compulsion

Relief

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Obsessive-Compulsive Disorder

§ Common obsessions:– Contamination– Images (e.g., violent scenes)– Urges (e.g., stab someone)– Order, exactness– Religious obsessions

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Obsessive-Compulsive Disorder

§ Common compulsions/rituals:– Cleaning/washing– Repeating – Checking– Counting/repeating words

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Hoarding Disorder

§ Ongoing difficulty throwing away or getting rid of possessions, regardless of actual value

§ Feel a need to save items, anxious to discard§ Results in cluttered living areas

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§ What is a mood?– A long-lasting emotion that affects how

one perceives the world– Emotions = “weather”

Mood = § Median age = 30

Mood Disorders

“climate”?

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Range of Emotions

DEPRESSION “Neutral”emotions

MANIAHappySad

“Normal”

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Brain chemistry

Mental processes

Mood

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Major Depressive Disorder

§ “Common cold” of mental illness§ Leading cause of disability in U.S. for ages

15-44§ Around 50% due to genes§ Lifetime rate = 17%

– about twice as high in women as men

74 75 76

Major Depressive Disorder

1. Depressed mood2. Loss of pleasure3. Weight/appetite

change4. Sleep changes

5. Restless OR slowed activity level

6. Loss of energy7. Worthlessness/guilt8. Poor concentration9. Thoughts of death

§ 5 or more symptoms in 2 week period

Severe, acute depression

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Persistent Depressive Disorder

1. Depressed mood most days for 2+ years2. Changes in eating3. Changes in sleeping4. Fatigue5. Low self-esteem6. Poor concentration7. Hopelessness

2 or more

Chronic depression; can be mild or severe

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Seasonal Affective Disorder(SAD)

§ Symptoms of major depressive disorder during fall and winter– Related to light– In U.S., higher rates further north– More common in women

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SAD Rates in the U.S.

FL1.4%

NH9.7%

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Light Treatment for SAD

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Bipolar Disorder

§ 0.6% in US§ Severe mood swings

– mania and depression– “manic-depression”

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Bipolar Disorder

A. At least 1 week of abnormally elevated, expansive, irritable mood

B. 3 or more of following:

1. Inflated self-esteem2. Decreased need for

sleep3. More talkative4. Racing thoughts

5. Distractibility6. Restlessness7. Activities with high risk

of painful consequences

1. At least one major depressive episode2. At least one manic episode

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A Typical Bipolar Cycle

Moo

d

Mania

Depression

1 2 3 4Years

1 cycle overseveral years

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Bipolar Disorder - Rapid Cycling

Moo

d

Mania

Depression

4 or more cycles

per year

1 Year88

Suicide Facts§ About 15% with depression commit suicide§ Over 40,000 in 2015 § 1999-2014, rate up 24%§ Fewest = § Women 3x more likely to attempt§ Men nearly 4x more likely to die from suicide

– 70% of suicides are white males§ Firearms most common method, almost 50%§ 2nd leading cause of death for 15-24s§ Highest rate =

winter; most = spring

men over 7589

US Daily Suicide Average by Month, 1999-2013

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Gender Differences in Suicide Method

56%

24%

13%

30%21%

40%

0%

10%

20%

30%

40%

50%

60%

Firearms Suffocation Poisoning

MenWomen

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6

93 95

Schizophrenia§ Not defined by any single symptom§ People with schizophrenia vary a great

deal§ Cognitive, behavioral, and emotional

problems

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Schizophrenia§ Around 1% of population§ Onset

– Slow or sudden– Late teens to mid-30s– Men - early to mid-20s– Women – late 20s

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Schizophrenia§ Strong genetic link (about 80%)

– If parents have it, risk = 10%– When 1 identical twin has it,

risk around 50%§ Combinations of genes predict sets of

symptoms§ Recent study (2014) shows that there

are eight distinct genetic disorders

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Schizophrenia: Prognosis

Three main outcomes:§ Small percentage recover completely§ Most continue to need help, and spend

time in hospital when symptoms return§ Some get worse over time

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Schizophrenia: Symptoms

Two or more of the following, during a 1-month period:1. Delusions2. Hallucinations3. Disorganized speech4. Disorganized or catatonic behavior5. Negative symptoms

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1. Delusions§ False beliefs

A. Persecution§ Belief that you’ll be harmed

B. Reference§ Certain gestures/comments/etc.

are directed at youC. Grandeur

§ Belief that you have exceptional abilities/wealth/fame

§ Bizarre vs non-bizarre

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2. Hallucinations

§ False perceptions§ Any of the senses§ Most common = hearing voices (auditory)

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3. Disorganized Speech§ Seen as sign of disorganized thinking

A. Loose associations§ Thoughts unrelated

B. Poverty of content§ Many words, little meaning

C. Clanging§ Words that rhyme or sound similar

D. Word salad§ Words jumbled together

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§ DisorganizedA. Problems in goal-directed behaviorB. Inappropriate sexual behaviorC. Unpredictable agitation

4. Grossly Disorganized or Catatonic Behavior

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4. Grossly Disorganized or Catatonic Behavior

§ Catatonic BehaviorA. StuporB. PosturingC. Waxy flexibility

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5. Negative Symptoms

§ Absence of certain normal behaviors1. Emotions2. Speech3. Goal-directed behavior

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Understanding Schizophrenia

1. Brain Abnormalities– Excessive dopamine levels– Abnormal brain activity– Tissue loss

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Understanding Schizophrenia

2. Prenatal Environment– Prenatal malnutrition– Maternal viral infections– Born during late winter/early spring

q Reversed below equator

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Possible Risk Factors

§ Urban environment§ Fathers’ age at birth, esp. 50+§ Twice as common in unmarried or

divorced people

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