13-1 * Chapter 13 Psychological Disorders


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13-1 * Chapter 13 Psychological Disorders

  1. 1. Chapter 13 Psychological Disorders Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
  2. 2. Defining and Classifying <ul><li>Historical Explanations of Abnormal Behaviors </li></ul><ul><ul><li>Demonic possession </li></ul></ul><ul><ul><li>Physical diseases </li></ul></ul><ul><ul><li>Products of psychological conflicts </li></ul></ul><ul><ul><li>Learned maladaptive behaviors </li></ul></ul><ul><ul><li>Distorted perceptions of the world </li></ul></ul>
  3. 3. Defining and Classifying <ul><li>Vulnerability-Stress Model </li></ul><ul><ul><li>Each of us has vulnerability for developing a psychological disorder </li></ul></ul><ul><ul><li>Stress plays a role in development </li></ul></ul>
  4. 5. Defining and Classifying <ul><li>Criteria for “abnormality” </li></ul><ul><ul><li>Distress </li></ul></ul><ul><ul><li>Dysfunction </li></ul></ul><ul><ul><li>Deviance </li></ul></ul>
  5. 6. Defining and Classifying <ul><li>Distress </li></ul><ul><ul><li>Judgments of abnormality most likely when distress is disproportionately acute or long-lasting </li></ul></ul>
  6. 7. Defining and Classifying <ul><li>Dysfunctionality </li></ul><ul><ul><li>Either for individual or for society </li></ul></ul>
  7. 8. Defining and Classifying <ul><li>Deviance </li></ul><ul><ul><li>From cultural norms </li></ul></ul>
  8. 9. Defining and Classifying <ul><li>What is Abnormal Behavior? </li></ul><ul><ul><li>Behavior that is so: </li></ul></ul><ul><ul><ul><li>Personally distressful </li></ul></ul></ul><ul><ul><ul><li>Personally dysfunctional </li></ul></ul></ul><ul><ul><ul><li>Culturally deviant </li></ul></ul></ul><ul><ul><li>that others judge it as inappropriate or maladaptive </li></ul></ul>
  9. 11. Defining and Classifying <ul><li>Diagnosing Psychological Disorders </li></ul><ul><ul><li>Reliability </li></ul></ul><ul><ul><ul><li>Clinicians should show high levels of agreement in their diagnostic decisions </li></ul></ul></ul>
  10. 12. Defining and Classifying <ul><li>Diagnosing Psychological Disorders </li></ul><ul><ul><li>Validity </li></ul></ul><ul><ul><ul><li>Diagnostic categories should accurately capture essential features of disorders </li></ul></ul></ul>
  11. 13. Defining and Classifying <ul><li>DSM-IV </li></ul><ul><ul><li>Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition </li></ul></ul><ul><ul><li>Most widely used classification system in U.S. </li></ul></ul>
  12. 14. Defining and Classifying <ul><li>DSM-IV Axes </li></ul><ul><ul><li>Axis I: Primary clinical symptoms </li></ul></ul><ul><ul><li>Axis II: Long-standing personality or developmental disorders </li></ul></ul><ul><ul><li>Axis III: Relevant physical conditions </li></ul></ul>
  13. 15. Defining and Classifying <ul><li>DSM-IV Axes cont. </li></ul><ul><ul><li>Axis IV: Intensity of environmental stressors </li></ul></ul><ul><ul><li>Axis V: Coping resources as reflected in recent adaptive functioning </li></ul></ul>
  14. 16. Defining and Classifying <ul><li>Consequences of Diagnostic Labeling </li></ul><ul><ul><li>Social </li></ul></ul><ul><ul><li>Personal </li></ul></ul><ul><ul><li>Legal </li></ul></ul>
  15. 17. Defining and Classifying <ul><li>Social Consequences of Diagnostic Labeling </li></ul><ul><ul><li>Becomes too easy to accept label as description of the individual </li></ul></ul>
  16. 18. Defining and Classifying <ul><li>Personal Consequences of Diagnostic Labeling </li></ul><ul><ul><li>May accept the new identity implied by the label </li></ul></ul><ul><ul><li>May develop the expected role and outlook </li></ul></ul>
  17. 19. Defining and Classifying <ul><li>Legal Consequences of Diagnostic Labeling </li></ul><ul><ul><li>Involuntary commitment to mental institutions </li></ul></ul><ul><ul><li>Loss of civil rights </li></ul></ul><ul><ul><li>Indefinite detainment </li></ul></ul>
  18. 20. Defining and Classifying <ul><li>Legal Concepts </li></ul><ul><ul><li>Competency </li></ul></ul><ul><ul><ul><li>Defendant’s state of mind at the time of a judicial hearing </li></ul></ul></ul><ul><ul><li>Insanity </li></ul></ul><ul><ul><ul><li>Presumed state of mind of defendant at time crime was committed </li></ul></ul></ul>
  19. 21. Anxiety Disorders <ul><li>Definition </li></ul><ul><ul><li>Frequency and intensity of anxiety responses are out of proportion to the situations that trigger them </li></ul></ul><ul><ul><li>Anxiety interferes with daily life </li></ul></ul>
  20. 22. Anxiety Disorders <ul><li>Components of Anxiety Responses </li></ul><ul><ul><li>Subjective-emotional </li></ul></ul><ul><ul><li>Cognitive </li></ul></ul><ul><ul><li>Physiological </li></ul></ul><ul><ul><li>Behavioral </li></ul></ul>
  21. 24. Anxiety Disorders <ul><li>Phobias </li></ul><ul><ul><li>Strong and irrational fears of certain objects or situations </li></ul></ul>
  22. 25. Anxiety Disorders <ul><li>Agoraphobia: Fear of open and public spaces from which escape would be difficult </li></ul><ul><li>Social phobias: Fear of situations in which evaluation might occur </li></ul>
  23. 26. Anxiety Disorders <ul><li>Specific phobias: Fear of specific objects such as animals or situations </li></ul>
  24. 27. Anxiety Disorders <ul><li>Generalized Anxiety Disorder </li></ul><ul><ul><li>Chronic state of diffuse, “free-floating” anxiety </li></ul></ul><ul><ul><li>Anxiety not attached to specific objects or situations </li></ul></ul>
  25. 28. Anxiety Disorders <ul><li>Panic Disorder </li></ul><ul><ul><li>Panic occurs suddenly and unpredictably </li></ul></ul><ul><ul><li>Much more intense than typical anxiety </li></ul></ul>
  26. 32. Anxiety Disorders <ul><li>Obsessive-Compulsive Disorder </li></ul><ul><ul><li>Obsessions </li></ul></ul><ul><ul><ul><li>Repetitive and unwelcome thoughts, images, or impulses </li></ul></ul></ul><ul><ul><li>Compulsions </li></ul></ul><ul><ul><ul><li>Repetitive behavioral responses </li></ul></ul></ul>
  27. 33. Anxiety Disorders <ul><li>Posttraumatic Stress Disorder </li></ul><ul><ul><li>Severe anxiety disorder </li></ul></ul><ul><ul><li>Can occur in people exposed to extreme trauma </li></ul></ul>
  28. 34. Anxiety Disorders <ul><li>Symptoms of PTSD </li></ul><ul><ul><li>Severe symptoms of anxiety, arousal, and distress </li></ul></ul><ul><ul><li>Reliving of trauma in flashbacks </li></ul></ul><ul><ul><li>Numb to world and avoidance of reminders </li></ul></ul><ul><ul><li>Intense “survivor guilt” </li></ul></ul>
  29. 35. Anxiety Disorders <ul><li>Biological Factors in Anxiety </li></ul><ul><ul><li>Overreactive autonomic nervous system </li></ul></ul><ul><ul><li>Overreactive neurotransmitter systems involved in emotional responses </li></ul></ul><ul><ul><li>Overreactive right hemisphere sites involved in emotions </li></ul></ul>
  30. 36. Anxiety Disorders <ul><li>Evolutionary Explanations </li></ul><ul><ul><li>Biological preparedness </li></ul></ul><ul><ul><ul><li>Makes it easier for us to learn to fear certain stimuli </li></ul></ul></ul>
  31. 37. Anxiety Disorders <ul><li>Psychodynamic Theory </li></ul><ul><ul><li>Neurotic anxiety </li></ul></ul><ul><ul><ul><li>Occurs when unacceptable impulses threaten to overwhelm the ego’s defenses </li></ul></ul></ul>
  32. 38. Anxiety Disorders <ul><li>Cognitive Factors </li></ul><ul><ul><li>Maladaptive thought patterns and beliefs </li></ul></ul><ul><ul><li>Exaggerated misinterpretations of stimuli </li></ul></ul>
  33. 39. Anxiety Disorders <ul><li>Learned Responses </li></ul><ul><ul><li>Result of “emotional conditioning” (Öhman, 2000; Rachman, 1998) </li></ul></ul><ul><ul><li>Classically conditioned fear </li></ul></ul><ul><ul><li>Observational learning </li></ul></ul>
  34. 40. Anxiety Disorders <ul><li>Culture-Bound Disorders </li></ul><ul><ul><ul><li>Occur only in certain locales </li></ul></ul></ul><ul><ul><ul><li>e.g., Anorexia Nervosa, Taijin Kyofushu </li></ul></ul></ul>
  35. 41. Somatoform Disorders <ul><li>Involve physical complaints that suggest a medical problem </li></ul><ul><li>But no biological cause </li></ul>
  36. 42. Somatoform Disorders <ul><li>Hypochondriasis </li></ul><ul><ul><li>Great alarm about physical symptoms </li></ul></ul><ul><ul><li>Convinced of serious illness </li></ul></ul>
  37. 43. Somatoform Disorders <ul><li>Pain Disorder </li></ul><ul><ul><li>Experience of intense pain out of proportion to medical conditions </li></ul></ul><ul><ul><li>No physical basis for </li></ul></ul>
  38. 44. Somatoform Disorders <ul><li>Conversion Disorder </li></ul><ul><ul><li>Serious neurological disorders suddenly occur </li></ul></ul><ul><ul><li>e.g., paralysis, loss of sensation, blindness </li></ul></ul>
  39. 45. Glove Actual nerve anethesia innervation
  40. 46. Somatoform Disorders <ul><li>Predispositions </li></ul><ul><ul><li>May involve combinations of biological and psychological vulnerabilities </li></ul></ul><ul><ul><li>Genetics, environmental learning, and social reinforcement for bodily symptoms (Trimble, 2003) </li></ul></ul>
  41. 47. Somatoform Disorders <ul><li>Incidence (Tanaka-Matsumi & Draguns, 1997) </li></ul><ul><ul><li>Higher in cultures that: </li></ul></ul><ul><ul><ul><li>Discourage open discussion of emotions </li></ul></ul></ul><ul><ul><ul><li>Stigmatize psychological disorders </li></ul></ul></ul>
  42. 48. Dissociative Disorders <ul><li>Breakdown of normal personality integration </li></ul><ul><ul><li>Results in alterations to memory or identity </li></ul></ul>
  43. 49. Dissociative Disorders <ul><li>Psychogenic Amnesia </li></ul><ul><ul><li>Response to stressful event with extensive but selective memory loss </li></ul></ul>
  44. 50. Dissociative Disorders <ul><li>Psychogenic Fugue </li></ul><ul><ul><li>Loss of all sense of personal identity </li></ul></ul><ul><ul><li>Establishment of new identity in a new location </li></ul></ul>
  45. 51. Dissociative Disorders <ul><li>Dissociative Identity Disorder (DID) </li></ul><ul><ul><li>Formerly called multiple personality disorder </li></ul></ul><ul><ul><li>Two or more separate personalities coexist in the same person </li></ul></ul>
  46. 52. Dissociative Disorders <ul><li>Causes of DID </li></ul><ul><ul><li>Trauma-Dissociation Theory </li></ul></ul><ul><ul><ul><li>Development of personalities is a response to severe stress </li></ul></ul></ul>
  47. 53. Dissociative Disorders <ul><li>Criticisms of DID </li></ul><ul><ul><li>Large increase in cases in recent years </li></ul></ul><ul><ul><li>Are personalities unintentionally implanted by overzealous therapists? </li></ul></ul>
  48. 54. Mood (Affective) Disorders <ul><li>Involve depression and mania </li></ul><ul><li>Most frequently experienced (with anxiety disorders) psychological disorders </li></ul>
  49. 55. Mood (Affective) Disorders <ul><li>Major Depression </li></ul><ul><ul><li>Intense depressed state </li></ul></ul><ul><ul><li>Leaves people unable to function effectively in their lives </li></ul></ul>
  50. 56. Mood (Affective) Disorders <ul><li>Dysthymia </li></ul><ul><ul><li>Intense form of depression </li></ul></ul><ul><ul><li>Less dramatic effects on personal and occupational functioning </li></ul></ul><ul><ul><li>More chronic than major depression </li></ul></ul>
  51. 57. Mood (Affective) Disorders <ul><li>Symptoms of Depression </li></ul><ul><ul><li>Negative mood </li></ul></ul><ul><ul><li>Cognitive symptoms </li></ul></ul><ul><ul><li>Motivational symptoms </li></ul></ul><ul><ul><li>Somatic (physical) symptoms </li></ul></ul>
  52. 60. Mood (Affective) Disorders <ul><li>Negative Mood in Depression </li></ul><ul><ul><li>Sadness, misery, loneliness </li></ul></ul><ul><ul><li>Loss of capacity for psychological, biological pleasures </li></ul></ul>
  53. 61. Mood (Affective) Disorders <ul><li>Cognitive Symptoms of Depression </li></ul><ul><ul><li>Difficulty concentrating and making decisions </li></ul></ul><ul><ul><li>Low self-esteem </li></ul></ul><ul><ul><li>Feelings of inferiority </li></ul></ul><ul><ul><li>Blame selves for failures </li></ul></ul><ul><ul><li>Pessimism and hopelessness </li></ul></ul>
  54. 62. Mood (Affective) Disorders <ul><li>Motivational Symptoms of Depression </li></ul><ul><ul><li>Inability to get started on task </li></ul></ul><ul><ul><li>Inability to perform behaviors leading to pleasure or accomplishment </li></ul></ul>
  55. 63. Mood (Affective) Disorders <ul><li>Somatic (Bodily) Symptoms of Depression </li></ul><ul><ul><li>Loss of appetite and weight loss in moderate and severe depression </li></ul></ul><ul><ul><li>Weight gain in mild depression </li></ul></ul>
  56. 64. Mood (Affective) Disorders <ul><li>Bipolar Disorder </li></ul><ul><ul><li>Depression alternates with periods of mania </li></ul></ul><ul><ul><li>Mania = Highly excited mood and behavior </li></ul></ul>
  57. 65. Mood (Affective) Disorders <ul><li>Prevalence of Mood Disorders </li></ul><ul><ul><li>1 in 20 Americans is severely depressed (Narrow et al., 2002) </li></ul></ul><ul><ul><li>1 in 5 Americans will have a depressive episode of clinical proportions during lifetime (Hamilton, 1989) </li></ul></ul>
  58. 66. Mood (Affective) Disorders <ul><li>Gender Differences </li></ul><ul><ul><li>Women about twice as likely to suffer from unipolar depression </li></ul></ul>
  59. 67. Mood (Affective) Disorders <ul><li>Biological Explanations for Gender Differences in Depression </li></ul><ul><ul><li>Genetic factors </li></ul></ul><ul><ul><li>Biochemical differences </li></ul></ul><ul><ul><li>Premenstrual depression </li></ul></ul>
  60. 68. Mood (Affective) Disorders <ul><li>Environmental Explanations for Gender Differences in Depression (Nolen-Hoeksma, 1990) </li></ul><ul><ul><ul><li>Female passivity and dependency </li></ul></ul></ul><ul><ul><ul><li>Distraction by physical activity and drinking in males </li></ul></ul></ul>
  61. 69. Mood (Affective) Disorders <ul><li>Patterns After Depressive Episodes </li></ul><ul><ul><li>No recurrence of clinical depression </li></ul></ul><ul><ul><li>Recovery with recurrence </li></ul></ul><ul><ul><li>No recovery </li></ul></ul>
  62. 70. Mood (Affective) Disorders <ul><li>Genetic Factors </li></ul><ul><ul><li>67% concordance rate for identical twins; only 15% for fraternal twins (Gershon et al., 1989) </li></ul></ul><ul><ul><li>Genetic predisposition to mood disorder </li></ul></ul>
  63. 72. Mood (Affective) Disorders <ul><li>Brain Chemistry Factors </li></ul><ul><ul><li>Underactivity of norepinephrine, dopamine, and serotonin in depression (Davidson, 1998) </li></ul></ul><ul><ul><li>Overactivity of neurotransmitters in mania? </li></ul></ul>
  64. 73. Mood (Affective) Disorders <ul><li>Psychological Factors </li></ul><ul><ul><li>Early traumatic losses or rejections create vulnerability (e.g. Abraham, 1911; Freud, 1917, Brown and Harris, 1978) </li></ul></ul>
  65. 74. Mood (Affective) Disorders <ul><li>Humanistic Factors </li></ul><ul><ul><li>Definition of self-worth in terms of individual attainment </li></ul></ul><ul><ul><li>React more strongly to failures; view failures as due to inadequacies </li></ul></ul><ul><ul><li>Experience of meaninglessness </li></ul></ul>
  66. 75. Mood (Affective) Disorders <ul><li>Depressive Cognitive Triad (Wenzlaff et al., 1988) </li></ul><ul><ul><li>Negative thoughts concerning: </li></ul></ul><ul><ul><ul><li>The world </li></ul></ul></ul><ul><ul><ul><li>Oneself </li></ul></ul></ul><ul><ul><ul><li>The future </li></ul></ul></ul>
  67. 76. Mood (Affective) Disorders <ul><li>Depressive Attributional Pattern </li></ul><ul><ul><li>Attributing success to factors outside self </li></ul></ul><ul><ul><li>Attributing negative outcomes to personal factors </li></ul></ul>
  68. 78. Mood (Affective) Disorders <ul><li>Learned Helplessness Theory (Abramson et al., 1978; Seligman & Isaacowitz, 2000) </li></ul><ul><ul><li>Depression occurs when people expect that bad events will occur and they think that they can’t cope with them </li></ul></ul>
  69. 79. Mood (Affective) Disorders <ul><li>Environmental Factors (Hammen, 1991) </li></ul><ul><ul><li>Poor parenting </li></ul></ul><ul><ul><li>Many stressful experiences </li></ul></ul><ul><ul><li>Failure to develop good coping skills </li></ul></ul><ul><ul><li>Failure to develop positive self-concept </li></ul></ul>
  70. 80. Mood (Affective) Disorders <ul><li>Sociocultural Factors </li></ul><ul><ul><li>Prevalence of depressive disorders less in Hong Kong and Taiwan than in the West </li></ul></ul><ul><ul><li>Feelings of guilt and inadequacy are highest in North America and Western Europe </li></ul></ul>
  71. 81. Mood (Affective) Disorders <ul><li>Sociocultural Factors cont. </li></ul><ul><ul><li>Gender difference not found in developing countries </li></ul></ul>
  72. 82. Suicide <ul><li>Willful taking of one’s life </li></ul><ul><li>Second most frequent cause of death among high school and college students </li></ul><ul><li>Women attempt more suicides; men are more likely to kill selves </li></ul>
  73. 84. Suicide <ul><li>Motives for Suicide (Beck et al., 1979) </li></ul><ul><ul><li>Desire to end one’s life </li></ul></ul><ul><ul><li>Manipulation of others </li></ul></ul>
  74. 85. Suicide <ul><li>Warning Signs of Suicide </li></ul><ul><ul><li>Verbal or behavioral threat to kill self </li></ul></ul><ul><ul><li>History of previous attempts </li></ul></ul><ul><ul><li>Detailed plan that involves a lethal method </li></ul></ul>
  75. 86. Suicide <ul><li>Suicide Prevention </li></ul><ul><ul><li>Talk about it with the person </li></ul></ul><ul><ul><li>Provide social support and empathy </li></ul></ul>
  76. 87. Suicide <ul><li>Suicide Prevention cont. </li></ul><ul><ul><li>Help the person to consider positive future possibilities </li></ul></ul><ul><ul><li>Stay with the person and help him or her to seek professional assistance </li></ul></ul>
  77. 88. Schizophrenia <ul><li>Severe disturbances in (Herz & Marder, 2002): </li></ul><ul><ul><li>Thinking </li></ul></ul><ul><ul><li>Speech </li></ul></ul><ul><ul><li>Perception </li></ul></ul><ul><ul><li>Emotion </li></ul></ul><ul><ul><li>Behavior </li></ul></ul>
  78. 89. Schizophrenia <ul><li>Diagnosis of Schizophrenia (American Psychiatric Association, 1994, 2000) </li></ul><ul><ul><li>Misinterpretation of reality </li></ul></ul><ul><ul><li>Disordered attention, thought, perception </li></ul></ul><ul><ul><li>Withdrawal from social activities </li></ul></ul>
  79. 90. Schizophrenia <ul><li>Diagnosis of Schizophrenia cont. </li></ul><ul><ul><li>Strange or inappropriate communication </li></ul></ul><ul><ul><li>Neglect of personal grooming </li></ul></ul><ul><ul><li>Disorganized behavior </li></ul></ul>
  80. 91. Schizophrenia <ul><li>Delusions </li></ul><ul><ul><li>False beliefs that are sustained in the face of contrary evidence normally sufficient to destroy them </li></ul></ul>
  81. 92. Schizophrenia <ul><li>Hallucinations </li></ul><ul><ul><li>False perceptions that have a compelling sense of reality </li></ul></ul><ul><ul><li>Can be auditory or visual </li></ul></ul>
  82. 93. Schizophrenia <ul><li>Types of Affect </li></ul><ul><ul><li>Flat: No emotions at all </li></ul></ul><ul><ul><li>Inappropriate </li></ul></ul>
  83. 94. Schizophrenia <ul><li>Subtypes of Schizophrenia </li></ul><ul><ul><li>Paranoid </li></ul></ul><ul><ul><ul><li>Delusions of persecution and grandeur </li></ul></ul></ul>
  84. 95. Schizophrenia <ul><li>Subtypes of Schizophrenia </li></ul><ul><ul><li>Disorganized </li></ul></ul><ul><ul><ul><li>Confusion and incoherence </li></ul></ul></ul><ul><ul><ul><li>Severe deterioration of adaptive behavior </li></ul></ul></ul>
  85. 96. Schizophrenia <ul><li>Subtypes of Schizophrenia </li></ul><ul><ul><li>Catatonic </li></ul></ul><ul><ul><ul><li>Motor disturbances from muscular rigidity to random or repetitive movements </li></ul></ul></ul>
  86. 97. Schizophrenia <ul><li>Subtypes of Schizophrenia </li></ul><ul><ul><li>Undifferentiated </li></ul></ul><ul><ul><ul><li>Do not show enough specific criteria to be classified as paranoid, disorganized, or catatonic </li></ul></ul></ul>
  87. 98. Schizophrenia <ul><li>Positive Symptoms </li></ul><ul><ul><li>Bizarre behaviors such as delusions, hallucinations, and disordered speech, thinking </li></ul></ul><ul><li>Negative Symptoms </li></ul><ul><ul><li>Absence of normal reactions </li></ul></ul><ul><ul><li>e.g., emotional expression, motivation, normal speech </li></ul></ul>
  88. 99. Schizophrenia <ul><li>Positive Symptoms </li></ul><ul><ul><li>Better prognosis for later recovery </li></ul></ul>
  89. 100. Schizophrenia <ul><li>Biological Causes </li></ul><ul><ul><li>Genetic predisposition </li></ul></ul><ul><ul><li>Destruction of neural tissue (neurodegenerative hypothesis) </li></ul></ul><ul><ul><ul><li>Atrophy in brain regions that influence cognitions, emotions </li></ul></ul></ul>
  90. 101. Schizophrenia <ul><li>Dopamine hypothesis </li></ul><ul><ul><ul><li>Overactivity of the dopamine system in brain areas regulating emotions, motivations, and cognitions </li></ul></ul></ul>
  91. 102. Schizophrenia <ul><li>Psychological Factors </li></ul><ul><ul><li>Freud: extreme example of regression </li></ul></ul><ul><ul><li>Retreat from painful intrapersonal world </li></ul></ul><ul><ul><li>Chaotic sensory input </li></ul></ul><ul><ul><li>Deficits in frontal lobe executive functions </li></ul></ul>
  92. 103. Schizophrenia <ul><li>Environmental Factors </li></ul><ul><ul><li>Stressful life events </li></ul></ul><ul><ul><li>Family dynamics </li></ul></ul><ul><ul><li>Home environments high in expressed emotion (Vaughn & Leff, 1976) </li></ul></ul>
  93. 104. Schizophrenia <ul><li>Expressed Emotion </li></ul><ul><ul><li>High levels of criticism </li></ul></ul><ul><ul><li>High levels of hostility </li></ul></ul><ul><ul><li>Overinvolvement in person’s life </li></ul></ul>
  94. 105. Schizophrenia <ul><li>Sociocultural Factors </li></ul><ul><ul><li>Highest in lower socioeconomic populations </li></ul></ul><ul><ul><li>Causal or correlational? </li></ul></ul>
  95. 106. Schizophrenia <ul><li>Social Causation Hypothesis </li></ul><ul><ul><li>Higher prevalence of schizophrenia due to higher levels of stress </li></ul></ul><ul><li>Social Drift Hypothesis </li></ul><ul><ul><li>Deterioration of social and personal functioning causes drift into poverty </li></ul></ul>
  96. 107. Personality Disorders <ul><li>Stable, ingrained, inflexible, and maladaptive ways of thinking, feeling, and behaving </li></ul><ul><li>Increase likelihood of acquiring, maintaining several Axis I disorders </li></ul>
  97. 108. Personality Disorders <ul><li>Three Clusters: </li></ul><ul><ul><li>Dramatic and impulsive behaviors </li></ul></ul><ul><ul><li>Anxiety and fearfulness </li></ul></ul><ul><ul><li>Odd and eccentric behaviors </li></ul></ul>
  98. 109. Personality Disorders <ul><li>Antisocial Personality Disorder </li></ul><ul><ul><li>Psychopaths or sociopaths </li></ul></ul><ul><ul><li>3:1 male-female ratio </li></ul></ul><ul><ul><li>Lack a conscience </li></ul></ul><ul><ul><li>Fail to respond to punishment </li></ul></ul>
  99. 110. Personality Disorders <ul><li>Biological Causes of Antisocial Personality Disorder </li></ul><ul><ul><li>Genetic predisposition </li></ul></ul><ul><ul><li>Dysfunction in brain structures that govern self-control and emotional arousal? </li></ul></ul>
  100. 111. Personality Disorders <ul><li>Psychological Causes of Antisocial Personality Disorder </li></ul><ul><ul><li>Psychodynamic view: lack of a superego </li></ul></ul><ul><ul><li>Inability to develop conditioned fear responses when punished leads to poor impulse control </li></ul></ul>
  101. 112. Personality Disorders <ul><li>Psychological Causes of Antisocial Personality Disorder cont. </li></ul><ul><ul><li>Modeling of aggression </li></ul></ul><ul><ul><li>Parental inattention to children’s needs (Rutter, 1997) </li></ul></ul>
  102. 113. Personality Disorders <ul><li>Psychological Causes of Antisocial Personality Disorder cont. </li></ul><ul><ul><li>Exposure to deviant peers </li></ul></ul><ul><ul><li>Consistent failure to think about or anticipate long-term negative consequences of acts </li></ul></ul>
  103. 114. Childhood Disorders <ul><li>Over 20% of children aged 2-5 diagnosed with DSM-IV disorder (Lavigne et al., 1996) </li></ul><ul><li>Only about 40% of children with behavior disorders receive professional attention (Satcher, 1999) </li></ul>
  104. 115. Childhood Disorders <ul><li>Externalizing Disorders </li></ul><ul><ul><li>Disruptive and aggressive behaviors </li></ul></ul><ul><ul><li>e.g., ADHD </li></ul></ul>
  105. 116. Childhood Disorders <ul><li>ADHD (Attention Deficit/Hyperactivity Disorder) </li></ul><ul><ul><li>Attentional difficulties </li></ul></ul><ul><ul><li>Hyperactivity-impulsivity </li></ul></ul><ul><ul><li>Most common childhood disorder (7-10% of U.S. children) </li></ul></ul>
  106. 117. Childhood Disorders <ul><li>Causes of ADHD </li></ul><ul><ul><li>Genetic predispositions </li></ul></ul><ul><ul><li>Brain scans show no differences with “normals” </li></ul></ul><ul><ul><li>Environmental factors </li></ul></ul>
  107. 118. Childhood Disorders <ul><li>Other Externalizing Disorders </li></ul><ul><ul><li>Oppositional Defiant Disorder (ODD) </li></ul></ul><ul><ul><ul><li>Disobedient, defiant, hostile </li></ul></ul></ul><ul><ul><li>Conduct Disorder </li></ul></ul><ul><ul><ul><li>Violate social norms and show disregard for others’ rights </li></ul></ul></ul>
  108. 119. Childhood Disorders <ul><li>Internalizing Disorders </li></ul><ul><ul><li>Involve maladaptive thoughts and emotions </li></ul></ul><ul><ul><li>Include anxiety and mood disorders </li></ul></ul>
  109. 120. Dementia in Old Age <ul><li>Gradual loss of cognitive abilities </li></ul><ul><li>Accompanies brain deterioration </li></ul><ul><li>e.g., Alzheimer’s, Parkinson’s, Huntington’s, Creutzfeldt-Jakob Diseases </li></ul>
  110. 121. Dementia in Old Age <ul><li>Senile Dementia </li></ul><ul><ul><li>Dementia that begins after age 65 </li></ul></ul><ul><ul><li>2:1 female-male ratio </li></ul></ul><ul><ul><li>Onset is typically gradual </li></ul></ul><ul><ul><li>Over 1/2 cases resemble schizophrenia </li></ul></ul>
  111. 122. Dementia in Old Age <ul><li>Alzheimer’s Disease </li></ul><ul><ul><li>60% of senile dementias </li></ul></ul><ul><ul><li>Caused by deterioration in frontal and temporal lobes of brain </li></ul></ul><ul><ul><li>Plaques in brain </li></ul></ul><ul><ul><li>Destruction of cells that produce acetylcholine </li></ul></ul>