The caudate nucleus is located in the basal ganglia and is associated with initiation of learned, habitual motor activities Using drugs that increase Serotonin reduces the activity of the caudate nucleus and leads to a reduction in the obsessions and compulsions - people who recover from OCD using behavioral and cognitive therapies also show a reduction in activity in the caudate nucleus
neurotransmitters are associated with motivation and arousal drugs that augment NE or Serotonin have been found effective in treating depression Prozac is a serotonin reuptake inhibitor, making more Serotonin available
Keywords: definition of dissociation Some psychologists use the term repression for dissociative amnesia A problem is that we need to distinguish between normal forgetting and the extreme case of dissociative amnesia. Just because you can’t remember something from your past very well doesn’t mean you are dissociating. Amnesia can also be caused by a head injury or by drugs. This isn’t considered dissociative amnesia How can we tell other kinds of forgetting from dissociation? Sudden onset, related to emotional trauma absence of brain injury, drugs
keywords: causal theories of dissociative disorders
keywords: dissociative identity disorder, controversy over Spanos asked college students to pretend they were accused murderers being examined by a psychiatrist. When given hypnotic therapy the students often expressed a second personality which claimed to be the murderer. This raises the question of whether DID might arise in some cases as a strategy or ploy by the patient, not just to avoid prosecution for crimes but perhaps to avoid other negative situations. It is not suggested that all DID cases arise in this way, but perhaps the large increase in diagnosis can be accounted for in this way. The increase in incidence in the 1980s was preceded by heightened awareness of the the stories of THE THREE FACES OF EVE and SYBIL which became known in the 1960’s
keywords: schizophrenia, the dopamine theory A problem for the theory: Drugs that reduce dopamine do reduce Sz symptoms, but the effects on dopamine function in the brain and on behavior have different time courses. On treatment with dopamine blocking drugs receptor function in the brain is affected almost immediately but reduction of symptoms is delayed by days or weeks. Some drugs that increase dopamine and that may induce sz-like positive symptoms include amphetamines and cocaine. When drug therapy first became available it was regarded as a major breakthrough in the treatment of mental disease by medical means
keywords: schizophrenia, congenital influences Increased risk has been observed for those born in a country where there was a flu epidemic during their gestation. The months of above average risk births are reversed between the northern and southern hemispheres, as are the flu seasons.
•Psychopathology—scientific studyof the origins, symptoms, anddevelopment of psychologicaldisorders•Psychological disorder or mentaldisorder--A pattern of behavioral andpsychological symptoms that causessignificant personal distress, impairsthe ability to function in one or moreimportant areas of daily life, or both
DiagnosisDiagnostic and Statistical Manual of MentalDisorders (DSM-IV-TR)—describes specificsymptoms and diagnostic guidelines forpsychological disorders– Provides a common language to labelmental disorders– Comprehensive guidelines to helpdiagnose mental disorders
Some DSM-IV-TR CategoriesCategory Features ExamplesInfancy,Childhood,or adolescentSymptomsusually diagnosedin childhoodAutistic DisorderTourette’sDisorderSubstance-related Effects of seekingor using drugsSubstance abuseEating disorders Disturbances inbody image,eatingAnorexia nervosaBulimia nervosaImpulse-controldisordersInability to resistactions that maybe harmfulKleptomania,pyromania
Prevalence of PsychologicalDisorders• Approximately 50% of adults experienced symptomsat least once in their lives (Kessler research)• Approximately 80% who experienced symptoms inthe last year did NOT seek treatment• Most people seem to deal with symptoms withoutcomplete debilitation• Women have a higher prevalence of depression andanxiety• Men have a higher prevalence of substance abuseand antisocial personality disorder
Anxiety Disorders• Primary disturbance isdistressing, persistent anxiety ormaladaptive behaviors that reduceanxiety• Anxiety—diffuse, vague feelingsof fear and apprehension
Generalized Anxiety Disorder(GAD)• More or less constant worry aboutmany issues• The worry seriously interferes withfunctioning• Physical symptoms– headaches– stomach aches– muscle tension– irritability
Model of Developmentof GAD• GAD has some genetic component• Related genetically to major depression• Childhood trauma also related to GADGenetic predispositionor childhood traumaGAD following lifechange or major eventHypervigilance
Panic Disorder• Panic attacks—sudden episode of helplessterror with high physiological arousal• Very frightening—sufferers live in fearof having them• Agoraphobia often develops as a result
Cognitive-behavioral Theory of PanicDisorder• Sufferers tend to misinterpret thephysical signs of arousal ascatastrophic and dangerous• This interpretation leads to furtherphysical arousal, tending toward avicious cycle• After the attack the person is veryapprehensive of another attack
PhobiasIntense, irrational fears that may focus on:• Natural environment—heights, water, lightening• Situation—flying, tunnels, crowds, socialgathering• Injury—needles, blood, dentist, doctor• Animals or insects—insects, snakes, bats, dogs
Some Unusual Phobias• Anemophobia: fear of wind• Aphephobia: fear of being touched byanother person• Catotrophobia: fear of breaking amirror• Gamophobia: fear of marriage• Phonophobia: fear of the sound ofyour own voice
Agoraphobia• Fear of panic attacks in public places• Avoid situations that might provoke apanic attack or where there may beno escape or help if a panic attackwere to come• Not everyone with panic disorderdevelops agoraphobia
Social Phobias• Social phobias—fear of social situations. Also calledsocial anxiety disorder. Stems from irrational fear ofbeing embarrassed or judged by others in public– public speaking (stage fright)– fear of crowds, strangers– meeting new people– eating in public• Considered phobic if these fears interfere with normalbehavior• More prevalent among women than men
Development of Phobias• Classical conditioning model– problems:• often no memory of a traumaticexperience• traumatic experience may not producephobia• Preparedness theory—phobia servesto enhance survival
Posttraumatic Stress Disorder(PTSD)• Follows events that produce intense horror orhelplessness (traumatic episodes)• Core symptoms include:– Frequent recollection of traumatic event, oftenintrusive and interfering with normal thoughts– Avoidance of situations that trigger recall of theevent– Increased physical arousal associated with stress
Obsessive-CompulsiveDisorder (OCD)• Obsessions—irrational, disturbing thoughts thatintrude into consciousness• Compulsions—repetitive actions performed toalleviate obsessions• Often accompanied by an irrational belief that failureto perform ritual action will lead to catastrophe• Checking and washing most common compulsions• Deficiency in serotonin implicated and heightenedneural activity in caudate nucleus
Mood DisordersA category of mental disorders in whichsignificant and chronic disruption inmood is the predominant symptom,causing impaired cognitive, behavioral,and physical functioning–Major depression–Dysthymic disorder–Bipolar disorder–Cyclothymic disorder
Major DepressionA mood disorder characterized by extremeand persistent feelings of despondency,worthlessness, and hopelessness– Prolonged, very severe symptoms– Passes without remission for at least 2weeks– Global negativity and pessimism– Very low self-esteem
Symptoms of Major Depression• Emotional—sadness, hopelessness, guilt, turning awayfrom others• Behavioral—tearfulness, dejected facial expression, lossof interest in normal activities, slowed movements andgestures, withdrawal from social activities• Cognitive—difficulty thinking and concentrating, globalnegativity, preoccupation with death/suicide• Physical—appetite and weight changes, excess ordiminished sleep, loss of energy, global anxiety,restlessness
Prevalence and Course of MajorDepression• Most common of psychological disorders• Women are twice as likely as men to bediagnosed with major depression• Untreated episodes can become recurringand more serious• Seasonal affective disorder (SAD)—onsetwith changing seasons
Dysthymic Disorder• Chronic, low-grade depressed feelingsthat are not severe enough to be majordepression• May develop in response to trauma, butdoes not decrease with time• Can have co-existing major depression
Seasonal Affective Disorder• Cyclic severe depression and elevated mood• Seasonal regularity• Unique cluster of symptoms– intense hunger– gain weight in winter– sleep more than usual– depressed more in evening than morning
Bipolar Disorders• Cyclic disorder (manic-depressive disorder)• Mood levels swing from severe depression toextreme euphoria (mania)• No regular relationship to time of year (SAD)• Must have at least one manic episode– Supreme self-confidence– Grandiose ideas and movements– Flight of ideas
Cyclothymic DisorderCyclothymic—mood disordercharacterized by moderate butfrequent mood swings that are notsevere enough to qualify as bipolardisorder
Prevalence and Course• Onset usually in young adulthood (early twenties)• Mood changes more abrupt than in majordepression• No gender differences in rate of bipolar disorder• Commonly recurs every few years• Can often be controlled by medication (lithium)
Explaining Mood Disorders• Neurotransmitter theories– dopamine– norepinephrine– serotonin• Genetic component– more closely related people show similarhistories of mood disorders
Situational Bases for Depression• Positive correlation between stressful lifeevents and onset of depression– Does life stress cause depression?• Most depressogenic life events arelosses– spouse or companion– long-term job– health– income
Cognitive Bases for Depression• Aaron Beck: depressed people holdpessimistic views of– themselves– the world– the future• Depressed people distort their experiences innegative ways– exaggerate bad experiences– minimize good experiences
Eating Disorders• Involve serious and maladaptivedisturbances in eating behavior,including reducing food intake, severeovereating, obsessive concerns aboutbody shape or weight
Two Main Types• Anorexia Nervosa-characterized byexcessive weight loss, irrational fear ofgaining weight, and distorted body self-perception• Bulimia Nervosa-characterized by bingesof extreme overeating followed by self-induced vomiting, misuse of laxatives, orother methods to purge
Causes of Eating Disorders• Perfectionism, rigid thinking, poor peerrelations, social isolation, low self-esteem associated with anorexia• Genetic factors implicated in both• Both involve decrease in serotonin
Personality DisordersInflexible, maladaptive pattern ofthoughts, emotions, behaviors, andinterpersonal functioning that are stableover time and across situations, anddeviate from the expectations of theindividual’s culture
Paranoid Personality Disorder• Pervasive mistrust and suspiciousness ofothers are the main characteristics• Distrustful even of close family and friends• Reluctant to form close relationships• Tend to blame others for their ownshortcomings• Occurs in about 3 percent of population,more frequent in men• Pathological jealousy seen in intimaterelationships
Antisocial Personality Disorder• Used to be called psychopath or sociopath• Evidence often seen in childhood (conductdisorder)• Manipulative, can be charming, can becruel and destructive• Seems to lack “conscience”• More prevalent in men than women
Borderline Personality Disorder• Chronic instability of emotions, self-image,relationships• Self-destructive behaviors• Intense fear of abandonment andemptiness• Possible history of childhood physical,emotional, or sexual abuse• 75% of diagnosed cases are women
Dissociative Disorders• What is dissociation?– literally a dis-association of memory– person suddenly becomes unaware of someaspect of their identity or history– unable to recall except under specialcircumstances (e.g., hypnosis)• Three types are recognized– dissociative amnesia– dissociative fugue– dissociative identity disorder
Dissociative Amnesia• Margie and her brother wererecently victims of a robbery.Margie was not injured, but herbrother was killed when he resistedthe robbers. Margie was unable torecall any details from the time ofthe incident until four days later.
Dissociative Amnesia• Also known as psychogenic amnesia• Memory loss the only symptom• Often selective loss surroundingtraumatic events– person still knows identity and most of their past• Can also be global– loss of identity without replacement with a newone
Dissociative FugueJay, a high school physics teacher in NewYork City, disappeared three days after hiswife unexpectedly left him for another man.Six months later, he was discoveredtending bar in Miami Beach. Callinghimself Martin, he claimed to have norecollection of his past life and insisted thathe had never been married.
Dissociative Fugue• Also known as psychogenic fugue• Global amnesia with identity replacement– leaves home– develops a new identity– apparently no recollection of former life– called a ‘fugue state’• If fugue wears off– old identity recovers– new identity is totally forgotten
Dissociative Identity Disorder(DID)Norma has frequent memory gaps and cannotaccount for her whereabouts during certainperiods of time. While being interviewed by aclinical psychologist, she began speaking in achildlike voice. She claimed that her name wasDonna and that she was only six years old.Moments later, she seemed to revert to her adultvoice and had no recollection of speaking in achildlike voice or claiming that her name wasDonna.
Dissociative Identity Disorder• Originally known as “multiple personalitydisorder”• 2 or more distinct personalities manifested bythe same person at different times• VERY rare and controversial disorder• Examples include Sybil, Trudy Chase, ChrisSizemore (“Eve”)• Has been tried as a criminal defense
Dissociative Identity Disorder• Pattern typically starts prior to age 10(childhood)• Most people with disorder are women• Most report recall of torture or sexualabuse as children and show symptomsof PTSD
Causes of DissociativeDisorders?• Repeated, severe sexual or physicalabuse• However, many abused people do notdevelop DID• Becomes a pathological defensemechanism to cope with intense feelingsof rage and anger
The DID Controversy• Some curious statistics– 1930–60: 2 cases per decade in USA– 1980s: 20,000 cases reported– many more cases in US than elsewhere– varies by therapist—some see none, otherssee a lot• Is DID the result of suggestion by therapistand acting by patient?
What is Schizophrenia?• Comes from Greek meaning “split” and “mind”– ‘split’ refers to loss of touch with reality– not dissociative state– not ‘split personality’
Symptoms of Schizophrenia• Positive symptoms– hallucinations– delusions• Negative symptoms– absence of normal cognition or affect (e.g., flataffect, poverty of speech)• Disorganized symptoms– disorganized speech (e.g., word salad)– disorganized behaviors
Symptoms of Schizophrenia• Delusions of persecution– ‘they’re out to get me’– paranoia• Delusions of grandeur– “God” complex– megalomania• Delusions of being controlled– the CIA is controlling my brain with a radio signal
Symptoms of Schizophrenia• Hallucinations– hearing or seeing things that aren’t there– contributes to delusions– command hallucinations: voices giving orders• Disorganized speech– Over-inclusion—jumping from idea to idea withoutthe benefit of logical association– Paralogic—on the surface, seems logical, butseriously flawed• e.g., Jesus was a man with a beard; I am a manwith a beard, therefore I am Jesus.
Symptoms of Schizophrenia• Disorganized behavior and affect– behavior is inappropriate for the situation• e.g., wearing sweaters and overcoats on hot days– affect is inappropriately expressed• flat affect—no emotion at all in face or speech• inappropriate affect—laughing at very serious things,crying at funny things– catatonic behavior• unresponsiveness to environment, usually marked byimmobility for extended periods
Frequency of positive and negative symptoms in individuals at the timethey were hospitalized for schizophrenia. Source: Based on data reported inAndreasen & Flaum, 1991.
Subtypes of Schizophrenia• Paranoid type– delusions of persecution• believes others are spying and plotting– delusions of grandeur• believes others are jealous, inferior,subservient• Catatonic type—unresponsive to surroundings,purposeless movement, parrot-like speech• Disorganized type– delusions and hallucinations with little meaning– disorganized speech, behavior, and flat affect
The Dopamine Theory• Drugs that reduce dopamine reducesymptoms• Drugs that increase dopamine producesymptoms even in people without thedisorder• Theory: Schizophrenia is caused by excessdopamine• Dopamine theory not enough; otherneurotransmitters involved as well
Biological Bases ofSchizophrenia• Other congenital influences– difficult birth (e.g., oxygen deprivation)– prenatal viral infection• Brain chemistry– neurotransmitter excesses or deficits– dopamine theory
Other Biological Factors• Brain structure and function– enlarged cerebral ventricles and reduced neuraltissue around the ventricles– PET scans show reduced frontal lobe activity• Early warning signs– nothing very reliable has been found yet– certain attention deficits can be found in childrenwho are at risk for the disorder• Father’s age—older men are at higher risk forfathering a child with schizophrenia
Family Influences onSchizophreniaFamily variables–parental communication that isdisorganized, hard-to-follow, or highlyemotional–expressed emotion• highly critical, over-enmeshedfamilies
Summary of Schizophrenia• Many biological factors seem involved– heredity– neurotransmitters– brain structure abnormalities• Family and cultural factors also important• Combined model of schizophrenia– biological predisposition combined withpsychosocial stressors leads to disorder– Is schizophrenia the maladaptive coping behaviorof a biologically vulnerable person?