Myers’ PSYCHOLOGY

Psychological Disorders

James A. McCubbin, PhD Clemson University

Worth Publishers David Rosenhan suspected that terms such as sanity, insanity, schizophrenia, mental illness, and abnormal might have fuzzier boundaries that the psychiatric community thought. He also suspected that some strange behaviors seen in mental patients might originate in the abnormal atmosphere of the mental hospital, rather than the patients themselves. Education ･AB, Yeshiva College, 1951 ･MA, Columbia University, 1953 ･PhD (psychology), Columbia University, 1958 Professor, Stanford University Dangers of Labeling

David Rosenhan Rosenhan & seven associates had themselves committed to different mental hospitals Being Sane in complaining of hearing voices. All but one were Insane Places diagnosed as schizophrenic. •Once admitted, they acted totally normal. In 1973 sociologist David Rosenhan •Remained hospitalized for average 19 days (9 to designed a clever 52) study to examine the •Only the patients detected their sanity difficulty that people •When discharged their chart read, have shedding the “schizophrenia in remission” "mentally ill" label. He was particularly No professional staff member at interested in how staffs in mental any of the hospitals ever realized institutions process that any of Rosenhan’s information about patients. pseudopatients was a fraud. According to a study conducted by the National Institute of mental health: *15.4% of the population suffers from diagnosible mental health problems *56 million Americans meet the criteria for a diagnosible psychological disorder (Carson 1996, Regier 1993) *Over the lifespan, +/- 32% of Americans will suffer from some psychological disorder. (Regier1988)

Normal or Abnormal? Not easy task: *Is Robin Williams normal? Marilyn Manson? *Is a soldier who risks his life or her life in combat normal? *Is a grief-stricken woman unable to return to her routine three months after her husband died normal? Is a man who climbs mountains as a hobby normal? Some abnormalities are easy: Hallucinations (false sensory experiences) Delusions (extreme disorders of thinking) Affective problems (emotion: depressed, anxious, or lack of emotion)

CORE CONCEPT: Medical model: takes a “disease” view Psychology model: interaction of biological, mental, social, and behavioral factors Psychological Disorder – a “harmful dysfunction” in which behavior is judged to be: • atypical- (not enough in itself) • disturbing- (varies with time & culture) • maladaptive- (harmful) • unjustifiable- (sometimes there’s a good reason) Show THE WORLD OF ABNORMAL BEHAVIOR: #1 Looking at Abnormal Behavior #2 The Nature of Stress Carol D. Ryff argues that we must define mental illness in terms of the positive. She names 6 core dimensions: 1) Self-acceptance: positive attitude towards self multiple aspects of self positive about past life 2) Positive self relations with other people: warm, trusting, satisfying interpersonal relationships capable of empathy, affection, intimacy 3) Autonomy independent, self-determined able to resist social pressures

4) Environmental mastery: sense of mastery and competence makes good use of opportunities creates contexts that support their personal needs 5) Purpose of Life: has goals and directedness feels there is meaning to past and present life 6) Personal Growth: see oneself as growing and expanding open to new experiences change in ways that reflect self-knowledge and effectiveness Historical Perspective

Perceived Causes *movements of sun or moon *lunacy- full moon *demons & evil spirits Ancient Treatments *exorcism, caged like animals, beaten, burned, castrated, mutilated, blood replaced with animal’s blood Historical Perspective

Hippocrates (400 bc) *first step in scientific view of mental disturbance. *imbalance (excess) among four body fluids called “humors”

Humors Origin Temperament Blood heart sanguine (cheerful)

Choler (yellow bile) liver choleric (angry)

Melancholer spleen melancholy (depressed) (black bile) Phlegm brain phlegmatic (sluggish) Psychological Disorders

Medical Model *concept that diseases have physical causes *can be diagnosed, treated, and in most cases, cured *assumes that these “mental” illnesses can be diagnosed on the basis of their symptoms and cured through therapy, which may include treatment in a psychiatric hospital Psychological Disorders Biological (Evolution, Bio-psycho-social individual Perspective genes, brain structures *assumes that biological, and chemistry) sociocultural, and psychological factors combine and interact to produce psychological disorders Psychological (Stress, trauma, Sociocultural learned helplessness, (Roles, expectations, mood-related perceptions definition of normality and memories) and disorder) Psychological Disorders- Etiology

DSM-IV-TR *American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) *a widely used system for classifying psychological disorders *presently distributed as DSM-IV-TR (text revision) *today used as “convenient shorthand” to avoid labeling. DSM-IV-TR organizes each psychiatric diagnosis into five levels (axes) relating to different aspects of the disorder or disability:

1) Axis 1 -- Clinical disorders including major mental disorders, as well as developmental or learning problems. Common disorders in this category include depression, bipolar, , ADHD, and schizophrenia. 2) Axis 2 -- Pervasive or personality disorders, including mental retardation. Common disorders in this category include borderline PD, schizotypal PD, narcissistic PD, antisocial PD, paranoid PD. DSM-IV-TR continued:

3) Axis 3 -- Acute medical conditions and physical disorders. Common disorders in this category include brain trauma, brain injury, brain disease.. 4) Axis 4 -- Psychosocial and environmental factors contributing to the disorder. Common factors in this category include a man suffering from depression after losing his job, or his wife dying, et. al. 5) Axis 5 -- Global Assessment of Functioning or Children’s Global Assessment Scale (under 18) Additions to DSM-IV The Insanity Defense Psychological Disorders- Etiology

Neurotic disorder (term seldom used now) *usually distressing but that allows one to think rationally and function socially *Freud saw the neurotic disorders as ways of dealing with anxiety Psychotic disorder *person loses contact with reality *experiences irrational ideas and distorted perceptions PREPAREDNESS HYPOTHESIS: Suggests that we have an innate biological tendency, acquired through natural selection, to respond quickly and automatically to stimulti that posed a survival threat to our ancestors. (Ohman & Mineka, 2001)

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QuickTime™ and a TIFF (Uncompres sed) decompres sor are needed to see this picture. This explains why we develop for snakes and lightening more easily than others. •ANXIETY DISORDERS •MOOD DISORDERS •DISSOCIATIVE DISORDERS •SCHIZOPHRENIA •PERSONALITY DISORDERS •BIOPSYCHOSOCIAL DISORDERS •SUBSTANCE ABUSE DISORDERS •SEXUAL DISORDERS •DEVELOPMENTAL (CHILDHOOD) DISORDERS ANXIETY DISORDERS 1) PANIC DISORDER w/AGORAPHOBIA 2) GENERALIZED ANXIETY DISORDER 3) PHOBIAS a) simple b) social c) agoraphobia 4) OBSESSIVE-COMPULSIVE DISORDER (OCD) 5) POST TRAUMATIC STRESS DISORDER (PTSD) 6) SOMOTOFORM a) hypochondria b) conversion (hysteria) Anxiety Disorders Anxiety Disorders *distressing, persistent anxiety or maladaptive behaviors that reduce anxiety Anxiety Disorders 1) Panic Disorder *marked by a minutes-long episode of intense dread in which a person experiences terror and accompanying chest pain, choking, racing heart, sweating, muscle- spasms, or other frightening sensations *common thinking patterns include: "I’m losing control.....” "I feel like I’m going crazy.....” "I must be having a heart attack.....” "I’m smothering and I can’t breathe.....”

1a) Panic Disorder w/Agoraphobia * of leaving home for fear of having a 2) Generalized Anxiety Disorder person is tense, apprehensive, and in a state of autonomic nervous system arousal

*Chronic (6 months) unrealistic or excessive worry about 2 or more elements in one’s life. 3) Phobias

a) Simple Excessive, irrational fear of objects or situations

b) Social Persistent fear of scrutiny by others doing something humiliating (stage fright or speech )

c) Agoraphobia Fear of being in a place or situation with no escape. (childhood environments in which one did not feel safe)

Anxiety Disorders Phobias persistent, irrational fear of a specific object or situation

Ablutophobia: washing, bathing Genophobia: sex Acrophobia: heights Gynephobia: women Algophobia: pain Ichthyophobia: fish Arachibutyrophobia: peanut butter Lutraphobia: otters sticking to roof of mouth Macrophobia: long waits Caligynephobia: beautiful women Medorthophobia: erect penis Cleptophobia: stealing Parthenophobia: virgins Demophobia: crowds Pophyrophobia: color purple Ecclesiophobia: church Somniphobia: sleep Ergophobia: work Testophobia: taking a test Anxiety Disorders Common and uncommon

100 Percentage 90 of people 80 surveyed 70 60 50 40 30 20 10 Snakes Being Mice Flying Being SpidersThunder Being Dogs Driving Being Cats in high, on an closed in, and and alone a car In a 0 exposed airplane in a insectslightning In a crowd places small house of people place at night Afraid of it Bothers slightly Not at all afraid of it Anxiety Disorders 4) Obsessive-Compulsive Disorder *unwanted repetitive thoughts (obsessions) and/or actions (compulsions) *feel obsessed w/something they do not want to think about and/or compelled to carry out some action, often pointlessly ritualistic.

*1 in 50 adults has OCD *Exact pathophysiologic process that underlies OCD has not been established. *Research suggests that abnormalities in serotonin (5-HT) transmission in the central nervous system are central to this disorder. *Supported by the efficacy of specific serotonin reuptake inhibitors (SSRIs) in the treatment of OCD. AS GOOD AS IT GETS Anxiety Disorders

Common Obsessions and Compulsions Among People With Obsessive-Compulsive Disorder

Thought or Behavior Percentage* Reporting Symptom Obsessions (repetitive thoughts) Concern with dirt, germs, or toxins 40 Something terrible happening (fire, death, illness) 40 Symmetry order, or exactness 24 Compulsions (repetitive behaviors) Excessive hand washing, bathing, tooth brushing, 85 or grooming Repeating rituals (in/out of a door, 51 up/down from a chair) Checking doors, locks, appliances, 46 car brake, homework Anxiety Disorders

• PET Scan of brain of person with Obsessive/ Compulsive disorder • High metabolic activity (red) in frontal lobe areas involved with directing attention Good examples of obsessions and their closely Obsession: A young related compulsions: woman is continuously Obsession: A mother tormented by terrified by the thought concern that she might inadvertently that cars might careen contaminate food as she cooks dinner. onto the sidewalk and run over her. Compulsion: Every day she sterilizes all cooking utensils in boiling water and Compulsion: She wears rubber gloves when handling food always walks as far from the street pavements as Obsession: A woman cannot rid herself possible and wears red of the thought that she might clothes so that she will accidentally leave her gas stove turned be immediately visible on, causing her house to explode to an out-of-control car. Compulsion: Every day she feels the irresistible urge to check the stove exactly 10 times before leaving for work. 5) Post Traumatic Stress Disorder (PTSD) Follows a psychologically distressing event that is outside the normal experience (rape, war, murder, beatings, torture, *1 in 12 adults in the U.S. natural disasters) suffer from PTSD *incessant reliving of event, recurring dreams, intrusive Perpetration-induced memories, flashbacks, traumatic stress (PITS) intensive fears, sleep *soldiers who had killed in combat problems. were found to suffer higher rates of PTSD than other troops *lasting biological effects: causes the brain’s hormone- *other studies include grief, survivor’s guilt, fear regulating system to develop hair-trigger responsiveness p341 Zim Holocaust Survivors Why do survivors of the Holocaust, a very traumatic experience, tended to show no signs of PTSD? *Differential Focus of Good= looking for good in their lives *Survival for some purpose = to tell the story Example of this *Psychological distancing would be Boys of *Mastery = helping others; create a sense of Buchenwald worthiness and self-esteem Group of four hundred *Will to live = human determination to live orphaned boys who has witnessed unimaginable *Hope horrors that were relocated *Social Support = drew social support from to orphanages in France. individual friendships or with others who Elie Wiesel shared the same life situation

5a) Stockholm Syndrome Follows a psychologically distressing event that is outside the normal experience (rape, war, murder, beatings, torture, natural disasters) *captor threatens to kill and is able to do so *victim cannot escape or life depends on the captor Example of this *victim is isolated from outsiders disorder would *captor is perceived as showing some degree be Patty Hearst of kindness Kidnapped by the *victim denies anger at abuser & focuses on Symbionese Liberation good qualities Army *”fight or flight” reactions are inhibited *victim fears interference by authorities--fears the captor will return from jail *victim is grateful to abuser for sparing her life 6) Somotoform Disorders Disorders, involving physical complaints for which no organic basis can be found.

a) Hypochondria Fear of having serious disease where no evidence of illness can be found.

b) Conversion (hysteria) Physical malfunction or loss of bodily control w/no underlying pathology but apparently related to psychological conflict.

TREATMENTS: *Medical model: antianxiety drugs (valium, librium, xanax) *Psychoanalysis: observational learning, childhood (mom/dad), free association, resistance (transference) *Learning Theories: classical conditioning, counterconditioning, systematic desensitization *Behaviorists: principles of learning, aversive conditioning, operant conditioning (token economy) *Cognitive Therapies: irrational interpretations *Humanistic: client-centered therapies, responsibility, active-listening. Show THE WORLD OF AbNORMAL BEHAVIOR: #3 The Anxiety Disorders

MOOD DISORDERS 1) DEPRESSIVE DISORDERS a) major depression b) dysthymia 2) BIPOLAR DISORDER a) mania b) major depression 3) SEASONAL AFFECTIVE DISORDER (SAD) Mood Disorders Mood Disorders characterized by emotional extremes

1) Depressive Disorders *most common disorders” a mood disorder in which a person, for no apparent reason, experiences two or more weeks of depressed moods, feelings of worthlessness, and diminished interest or pleasure in most activities

a) Major Depressive Disorder Unhappy for 2 weeks without reason, appetite changes, insomnia, inability to QuickTime™ and a TIFF (Uncompressed) decompressor are needed to see this picture. concentrate, worthlessness, hallucinations

b) Dysthymia Unhappy for over 2 years Mood Disorders 2) Bipolar Disorder *a mood disorder in which the person alternates between the hopelessness and lethargy of depression and the overexcited state of mania *formerly called manic-depressive disorder

a) Manic Episode a mood disorder marked by a hyperactive, wildly optimistic state, excessive excitement, silliness, poor judgment, abrasive, rapid flight of ideas

b) Major depression Lethargic, sleepy, social withdrawal, irritability

Symptoms of Mania 1) Mood or emotional symptoms: euphoric, expansive, and elevated. In some •Between .6 and cases, dominant mood is irritability. Even when 1.1 percent of euphoric, manic people are close to tears and if U.S. population frustrated, will burst out crying. will have bipolar 2) Grandiose cognition: manics believe no disorder in their limits to their abilities and do not recognize the lifetime. painful consequences of trying to carry out their •It affects both plans. May be delusional about themselves. sexes equally. 3) Motivational symptoms: hyperactivity has intrusive, dominating, domineering quality. Some •Onset is sudden. engage in compulsive gambling, reckless driving, •First episode or poor financial investment. occurs between 4) Physical symptoms: lessened need for ages 20 and 30. sleep. After a few days, exhaustion settles in. Mood Disorders-Bipolar

PET scans show that brain energy consumption rises and falls with emotional swings

Depressed state Manic state Depressed state Mood Disorders-Depression Mood Disorders-Depression

. Canadian depression rates

10% Percentage Females depressed 8 6

4 Males 2

0 12-17 18-24 25-34 35-44 45-54 55-64 65-74 75+

Age in Years Famous People with Bipolar Disorder 3) Seasonal Affective Disorder (SAD)

Experience depression during certain times of the year *usually winter (less sunlight) *treated w/light therapy *Alaska (dark for months)

Aaron Beck’s work with depressed patients convinced him that depression is primarily a disorder of thinking rather than of mood. He argued that depression can best be described as a cognitive triad or negative thoughts about oneself, the situation or the future.

Cognitive errors included the following: 1) overgeneralizing: drawing global conclusions about worth, ability, or performance on basis of single fact 2) Selective abstraction: focusing on one insignificant detail and ignoring others 3) Personalization: incorrectly taking responsibility for events in the world 4) Magnification & minimization: bad events magnified and good events minimized. 5) Arbitrary inference: drawing conclusions without sufficient evidence 6) Dichotomous thinking: seeing everything in one extreme or its opposite. Mood Disorders-Depression Altering any one Brain Cognition chemistry component of the chemistry- cognition-mood circuit can alter Mood the others

Generally speaking, a deficit of serotonin is associated with depression. Mood Disorders-Depression

Percentage of A happy or observations depressed 35% mood 30 strongly influences 25 people’s 20 ratings of their own 15 Negative Positive behavior behaviors behaviors Self-ratings Mood Disorders-Depression

The vicious 1 Stressful cycle of experiences depression can be 4 2 Cognitive and Negative broken at behavioral changes explanatory style any point

3 Depressed mood Mood Disorders-Depression

. Boys who were later convicted of a crime showed relatively low arousal EXAMPLES of Mood Disorders:

Andrea Yates: postpartum depression and the insanity plea. It has been suggested that at the far end of the postpartum psychological spectrum lie postpartum psychosis. In Andrea’s case, it represented a state of mind in which killing one’s children seemed the best way to protect them. Mood Disorders- Suicide Mood Disorders-Suicide

Increasing rates of teen suicide

12% Suicide rate, ages 15 to 19 10 (per 100,000) 8

6

4

2

0 1960 1970 1980 1990 2000 Year REASONS for suicide:

1) Unendurable psychological pain: if you reduce the pain just a little, most suicidal people will choose to live. 2) Frustrated psychological needs: (security, achievement, trust, friendship) 3) Search for a solution: Suicide is never done without purpose --“How do I get out of this?” 4) Attempt to end consciousness: goal is to stop awareness of painful existence. 5) Helplessness & hopelessness: loss of power 6) Constriction of options: Not seeing the broad picture; limited options. 7) Ambivalence: Some is normal--In typical case, victim cuts throat and calls for help. 8) Communication of intent: 80 percent gives clear clues to family & friends 9) Departure: quitting job, running away from home, leaving spouse are all departures but suicide is the ultimate departure. 10) Lifelong coping patterns: look for earlier episodes--often a style of problem solving that is characterized as “cut and run.” LONELINESS

Sharon Brehm reports that gender interacts with marital status in the following ways: •Married females report greater loneliness than do married males •Among those never married, males report more loneliness than do females •Among the separated and divorced, males report greater loneliness than do females •Among those whose spouse has died, males report greater loneliness than do females. REASONS for Loneliness

1) Being unattached 2) Alienation: being misunderstood & feeling different 3) Being alone: coming home to empty house 4) Forced isolation: hospitalized or housebound 5) Dislocation: starting new job or school

Four major strategies in coping with Loneliness: 1) Sad passivity: sleeping, drinking, overeating, watching TV 2) Social contact: calling friend 3) Active solitude: studying, reading, exercising, going to movie 4) Distractions: spending money, going shopping TREATMENTS:

*Medical model: For bipolar-- lithium carbonate, carbamazepine, and valproate. For depression--tricyclics; the newer selective serotonin re-uptake inhibitors (SSRIs), and monoamine oxidase inhibitors (MAO inhibitors). Electroconvulsive therapy (ECT) uses small amounts of electricity applied to the scalp to affect neurotransmitters in the brain. *Psychoanalysis: *Learning Theories: *Behaviorists: *Cognitive Therapies: interpersonal therapy

*Humanistic: client-centered therapies, responsibility, active-listening, emotional support and assistance in recognizing signs of relapse to avert a full-blown episode Show

THE MIND #31 Mood Disorders: Mania & Depression #32 Mood Disorders: Hereditary Factors #33 Mood Disorders: Medication and Talk Therapy

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THE WORLD OF AbNORMAL PSYCHOLOGY: #8 Mood Disorders DISSOCIATIVE DISORDERS 1) PSYCHOGENIC AMNESIA 2) PSYCHOGENIC FUGUE 3) DISSOCIATIVE IDENTITY DISORDER (Multiple Personality Disorder) 4) DEPERSONALIZATION DISORDER Dissociative Disorders

Dissociative Disorders – conscious awareness becomes separated (dissociated) from previous memories, thoughts, and feelings Dissociative Disorders

1) Psychogenic Amnesia – Sudden inability to recall important information--NOT as a result of physical “blow” or drug-related.

2) Psychogenic Fugue – Loss of memory--flees to a new location and establishes new lifestyle – After recovery, events during fugue are not remembered Dissociative Disorders 3) Dissociative Identity Disorder – rare dissociative disorder in which a person exhibits two or more distinct and alternating personalities – formerly called multiple personality disorder *often history of child or sex abuse In 2008, Herschal Walker, the 1982 Heisman Trophy winner from the University of Georgia, released his book “Breaking Free” which related his experiences with DID. He reported not being able to remember winning the Heisman in 1982 or darker events, such as threatening his then-wife. 4) Depersonalization Disorder – Persistent, recurring feelings that one is not real or is detached from one’s own experience or body. People with Dissociative Disorders may experience any of the following:

depression, eating disorders mood swings, headaches, suicidal tendencies, amnesias, sleep disorders (insomnia, night time loss, terrors, and sleep walking), trances, and "out of body panic attacks and phobias experiences." (flashbacks, reactions to stimuli self-persecution, or "triggers"), self-sabotage alcohol and drug abuse, violence (both self-inflicted and compulsions and rituals, outwardly directed). psychotic-like symptoms (including auditory and visual hallucinations), Dissociative Disorders are now understood Recent to be fairly common effects of severe research trauma in early childhood, most typically suggests the extreme, repeated physical, sexual, and/or risk of suicide emotional abuse. attempts Posttraumatic Stress among people Disorder (PTSD), widely with trauma There is accepted as a major mental disorders may evidence that illness affecting 8% of the be even higher people with general population in the than among trauma disorders United States, is closely people who have higher rates related to Dissociative have major of alcoholism, Disorders. In fact, 80-100% depression. chronic medical of people diagnosed with a illnesses, and Dissociative Disorder also abusiveness in have a secondary diagnosis succeeding of PTSD generations. TREATMENTS: *Medical model: therapy to recall the memories, hypnosis or a medication called Pentothal (thiopental) can sometimes help to restore the memories *Psychoanalysis: help an individual deal with the trauma associated with the recalled memories. Fugue--Hypnosis. Dissociative identity disorder-- long-term psychotherapy that helps the person merge his/her multiple personalities into one. *Learning Theories: *Behaviorists: *Cognitive Therapies: irrational interpretations *Humanistic: client-centered therapies, responsibility, active-listening. SHOW: Sybil Part I Sybil Part II PERSONALITY DISORDERS 1) Paranoid Personality Disorder (PPD) 2) Obsessive-Compulsive Personality Disorder(OCPD) 3) Antisocial Personality Disorder 4) Borderline Personality Disorder 5) Schizoid Personality Disorder 6) Schizotypal Personality Disorder 7) Narcissistic Personality Disorder Personality Disorders

Personality Disorders *disorders characterized by inflexible and enduring behavior patterns that impair social functioning *usually without anxiety, depression, or delusions Personality Disorder Types

1) Paranoid Personality Disorder Suspicious, envious, extreme jealousy, tendency to interpret actions of others as demeaning or threatening. Personality Disorder Types 2) Obsessive-Compulsive Personality Disorder *Obsession: Recurring thoughts or images that seems irrational & out of control (locking doors, worry, dying) *Compulsion: irresistible urge to act or engage in ritualistic behavior ***interferes with daily life Example: Howard Hughes

Treatment: A physician in this instance is best sticking with the facts of the presenting problem and underlying disorder rather than offering vague impressions of their opinion. Since the individual with this disorder tends to be meticulous and concerned with details, the treatment regimen -- once accepted -- will likely be adhered to rigorously, without incident. Personality Disorder Types 3) Antisocial Personality Disorder *disorder in which the person exhibits a lack of conscience for wrongdoing, even toward friends and family members *may be aggressive and ruthless or a clever con artist, no regard for truth, irresponsible behavior, failure to conform to social norms Treatment--Because many people who suffer *Intelligent, charming from this disorder will be mandated to *social skills therapy in a forensic or jail setting, *75% men motivation on the patient's part may be *Potentially dangerous difficult to find. Therapy should focus on alternative life issues, such as goals for when they are released from custody, improvement in social or family Example: relationships, learning new coping skills, etc. In an outpatient setting, the focus of Hannibal Lecter in therapy can also be on these types of issues, Silence of the but a part of the therapy should be devoted Lambs to discussing the antisocial behavior and feelings (or lack thereof). Personality Disorder Types 4) Borderline Personality Disorder *Unpredictable, impulsive, angry outbursts *Experiences guilt, remorse, & appropriate emotions Treatment: Dialectical Behavior Therapy: *75% female teaches the client how to learn to better take control of their lives, their emotions, and themselves through self-knowledge, emotion regulation, and cognitive restructuring. **Although carriers of this personality disorder are frequently found among street criminals and con artists, they are also well represented among successful politicians and business people who put career, money, and power above everything and everyone. **Two to three percent of the population in the U.S. may have antisocial personality disorder. **Chronic lying, stealing, and fighting are common signs. **Violations of social norms begin early in life-- disrupting class, getting into fights, and running away from home.

5) Schizoid Personality Disorder *Lack of interest in social relations *Inability to express feelings

6) Schizotypal Personality Disorder *Egocentricity, avoidance of others, eccentricity of thought *Oversensitive & frequently see chance events as related to themselves. *Individuals with this disorder usually distort reality more so than someone with Schizoid Personality Disorder. Personality Disorder Types

7) Narcissistic Personality Disorder *Preoccupied with receiving attention & nurturance *Exaggerated sense of self-importance Treatment: Hospitalization of patients with severe Narcissistic Personality occurs frequently, such as those who are quite impulsive or self-destructive, or who have poor reality-testing. Personality Disorders

• PET scans illustrate reduced activation in a murderer’s frontal cortex

Normal Murderer Personality Disorders

35 30

Percentage 25 of criminal 20 offenders 15 10 5 0

Total crime Thievery Violence

Childhood Obstetrical Both poverty poverty complications and obstetrical complications Rates of Psychological Disorders Percentage of Americans Who Have Ever Experienced Psychological Disorders Ethnicity Gender

Disorder White Black Hispanic Men Women Totals Alcohol abuse or dependence 13.6% 13.8% 16.7% 23.8% 4.6% 13.8%

Generalized anxiety 3.4 6.1 3.7 2.4 5.0 3.8

Phobia 9.7 23.4 12.2 10.4 17.7 14.3

Obsessive-compulsive disorder 2.6 2.3 1.8 2.0 3.0 2.6

Mood disorder 8.0 6.3 7.8 5.2 10.2 7.8

Schizophrenic disorder 1.4 2.1 0.8 1.2 1.7 1.5

Antisocial personality disorder 2.6 2.3 3.4 4.5 0.8 2.6 TREATMENTS:

*Medical model:

*Psychoanalysis: SchizoidPD--individual therapy (brief), SchizotypalPD- -the clinician must exercise care to not directly challenge delusional or inappropriate thoughts…warm, supportive, and client-centered environment should be established with initial rapport. *Learning Theories: *Behaviorists:

*Cognitive Therapies: BorderlinePD--Dialectical Behavior Therapy: teaches the client how to learn to better take control of their lives, their emotions, and themselves through self-knowledge, emotion regulation, and cognitive restructuring.

*Humanistic: Group setting (BPD), client-centered therapies (OCPD), responsibility, active-listening, NarcissisticPD--Small staff-patient groups--feelings are shared and patients' comments taken seriously by staff, constructive work assignments, recreational activities, and opportunities to sublimate painfully conflictual impulses. Show

THE MIND #35 The Mind of The Psychopath

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THE WORLD OF AbNORMAL PSYCHOLOGY: #5 Personality Disorders Gacy or Bundy

SCHIZOPHRENIC DISORDERS (also called Psychotic Disorders) Schizophrenia literally means “split mind,” meaning a split from reality that shows itself in disorganized thinking, disturbed perceptions and inappropriate emotions and actions.

The term coined by Emil Kraepelin, who established the diagnostic category “dementia praecox” and Eugen Bleuler, who introduced the term (1857-1939) 1874, Medicene, “schizophrenia.” Medicene, University Leipzig & Wurtzburg, of Bern Germany

PSYCHOTIC: split from reality Possible symptoms of psychotic illnesses include: *Disorganized or incoherent speech *Confused thinking *Strange, possibly dangerous behavior *Slowed or unusual movements *Loss of interest in personal hygiene *Loss of interest in activities *Problems at school or work and with relationships *Cold, detached manner with the inability to express emotion *Mood swings or other mood symptoms, such as depression or mania CAUSES: •chemical imbalances (“mad as a hatter”) •excess D4 dopamine receptors (in autopsies) (drugs that block dopamine receptors lessen the symptoms) •now researching neurotransmitter glutamate (direct neurons to pass along an impulse) •abnormal brain activity: low in frontal lobes •research shows (during hallucinations) increased activity in thalamus, amygdala, and cortex •greater than normal cerebral cortex tissue loss between ages 13 and 18. •genetics: enlarged, fluid-filled cranial cavities Identical Twin studies show: *48% probability of having schizophrenia if your twin does. *single placenta: 6 in 10 chance *separate placentas: 1 in 10 chance *one study showed the older the father, the greater risk of schizophrenia in offspring

The GENAIN QUADRUPLETS (b.1930) were monozygous women all suffered from schizophrenia, demonstrating a large genetic component to the disease. The girls (Nora, Iris, Myra, Hester) were fictitiously named for NIMH (National Institute of Mental Health). Both parents had mental disorders during their lifetime. A common finding in the brains of people with schizophrenia is larger than normal lateral ventricles.

significant vertical displacement of the lateral ventricles in corresponds to the displacement of the corpus callosum.

DIANTHESIS-STRESS HYPOTHESIS: The idea that biological factors may place the individual at risk for schizophrenia (or others), but environmental stressors transform this potential into an actual disorder.

1) DISORGANIZED 2) CATATONIC 3) PARANOID 4) UNDIFFERENTIATED 5) RESIDUAL

*6) PARANOID DELUSIONAL DISORDER 1) DISORGANIZED SCHIZOPHRENIC • confused and incoherent, • jumbled speech • emotionless or flat or inappropriate, even silly or childlike. (flat affect or lack of affect) • disorganized behavior that may disrupt their ability to perform normal daily activities (showering or preparing meals) • hallucinations and delusions Disorganized speech is of two types: NEOLOGISMS: “new words” “I had belly bad luck and brutal and outrageous.” (I have stomach problems and don’t feel good) “I gave all the work money. (I paid tokens for my meal) I was raised in packs (with other people) and since I was in littlehood (little girl) she blamed a few people with minor words (she scolded people).

WORD SALAD: “disorganization” The lion will have to change from dogs into cats until I can meet my father and mother and we depart some rats. I live on the front part of Whitton’s head. You have to work hard if you don’t get into bed. She did. She said, “Hallelujah, happy landings.” It’s all over for a squab true tray and there ain’t not squabs, there ain’t no men, there ain’t no music, there ain’t no nothing besides my mother and my father who stand alone upon the Island of Capri where there is no ice, there ain’t no nothing but changers, changers, changers……. 2) CATATONIC SCHIZOPHRENIC •Physical symptoms • immobile and unresponsive to the world around them • very rigid and stiff, unwilling to move • waxy flexibility • occasional grimacing or bizarre postures. • might repeat a word or phrase just spoken by another person. • increased risk of malnutrition, exhaustion, or self-inflicted injury.

Catatonic excitement: patients become agitated and hyperactive. 3) PARANOID SCHIZOPHRENIC • preoccupied with false beliefs (delusions) about being persecuted or being punished by someone • thinking, speech and emotions, however, remain fairly normal. •the paranoid delusions of persecution or grandiosity (highly-exaggerated self-importance) are less well organized--more illogical--than those of the patient with purely delusional disorder. •delusions are usually auditory 4) UNDIFFERENTIATED SCHIZOPHRENIC * diagnosed when the person's symptoms do not clearly represent one of the other three subtypes.

5) RESIDUAL SCHIZOPHRENIC * suffered from schizophrenia in the past but no hallucinations or delusions • mildly disturbed thinking • emotionally impoverished **6) PARANOID DELUSIONAL DISORDER • characterized by non-bizarre delusions in the absence of other mood or psychotic symptoms •delusions involving real-life situations that could be true, such as being followed, being conspired against or having a disease • delusions persist for at least one month. • non-bizarre refers to situations such as: being followed, being loved, having an infection, or being deceived by one’s spouse • needs to be evaluated with respect to religious and cultural differences. TREATMENTS:

*Medical model: Start: olanzapine (Zyprexa), quetiapine (Seroquel), risperidone (Risperdal), or aripiprazole (Abilify)….Then: chlorpromazine, fluphenazine, and haloperidol…. Last resort: Clozapine (Clozaril) (has side effects)

*Psychoanalysis: medication, psychological counseling and social support. *Learning Theories: *Behaviorists: medication, psychological counseling and social support. *Cognitive Therapies: *Humanistic: medication, psychological counseling and social support. Show ABC Schizophrenia And THE WORLD OF ABNORMAL PSYCHOLOGY #9 The Schizophrenias Mindstorm BIOPSYCHOSOCIAL DISORDERS

1) CORONARY HEART DISEASE 2) MIGRAINE HEADACHES 3) BREAST CANCER 4) ANOREXIA NERVOSA 5) BULIMIA NERVOSA

Biopsychosocial Disorders

1) Coronary Heart Disease (Ch 14, p. 539- 541) *Lethal blockage of arteries that supply blood to heart muscle *Causes: age, gender, family history, blood pressure, chloresterol, weight, lifestyle, psychological state (type A personality) Biopsychosocial Disorders

2) Migraine Headaches (not in book) *Intensely painful, recurring headache--reduced flow of bloodto certain parts of brain-- overarousal of sympathetic nervous system *Causes: stress, change in weather, hormonal changes *Family history ***Seeing zigzag lines or flashing lights, tingling, numbness in arms & legs. Biopsychosocial Disorders

3) Breast Cancer (Ch 14, p.543-544) *Over 50, no children, family history *Stressful life leads to higher level of the disease Swedish researchers say that being under stress may double a woman's risk of developing breast cancer.They based their findings on surveys of more than 1,400 Swedish women in the late 1960s who were part of a long-term health-care study. They found that women who reported being under stress had twice the risk of developing breast cancer as women who managed to stay cool, calm, and collected. Biopsychosocial Disorders 4) Anorexia Nervosa (Ch 12, p.454-467) *Eating disorder, intense abhorrence of obesity, insistance that one is fat *Loss of 25%+ original body fat

QuickTime™ and a TIFF (Uncompres sed) decompres sor *Refusal to maintain normal weight are needed to see this picture.

5) Bulimia Nervosa (Ch 12, p. 464-467) *Unable to stop eating voluntarily *Preoccupation with weight gain *Attempt to lose weight thru binge eating, self- induced vomiting & overuse of laxatives and diuretics QuickTime™ and a TIFF (Uncompressed) decompressor are needed to see this picture. A surplus of serotonin is associated with anorexia

1) INJURY 2) ALZHEIMERS DISEASE 3) KORSAKOFF’S SYNDROME 4) PARKINSON’S DISEASE

Neurophysical Disorders

1) Injury (not in book) *Brain trauma

2) Alzheimers (Ch 4, p 177-178) **trouble remembering recent events, activities, or the names of familiar people or things **Age (number of people w/disease doubles every 5 years past age 65 ) **family history (usually occurs between age 30-60 if it’s genetic). . . . One risk factor for this type of AD is a protein called apolipoprotein E (apoE). Neurophysical Disorders

3) Wernicke’s-Korsakoff’s Syndrome (not in book) *memory disorder caused by a lack of vitamin B1 (thiamine). *affects short-term memory. *Most common cause: alcoholism *A related disorder, Wernicke's syndrome, often occurs before Korsakoff's syndrome. Because they often occur together, the range of symptoms caused by the two diseases is often called Wernicke's-Korsakoff syndrome. The main symptoms of Wernicke's syndrome occur acutely. They include: • Difficulty with walking and balance • Confusion • Drowsiness • Paralysis of some eye muscles Neurophysical Disorders

3) Korsakoff’s Syndrome *Thiamine is necessary for memory and other brain functions. People who drink a lot of alcohol often replace food with alcohol. As a result, they take in fewer vitamins, leading to vitamin deficiencies. In addition, alcohol increases the body's need for B vitamins while interfering with its ability to absorb, store, and use thiamine.

*A genetic abnormality may make some people more susceptible to Korsakoff's syndrome when they drink large amounts of alcohol and consume diets low in vitamins. Neurophysical Disorders

4) Parkinson’s Syndrome (not in book) *tremor in hand, foot, mouth, or chin *stiffness or rigidity of the limbs and trunk *bradykinesia (slowness of movement) *postural instability, or impaired balance and coordination *Occurs in about 1% of people over 65, 15% in ages 74-85, and over 50% of people over 85 Neurophysical Disorders

• Parkinson’s Disease (not in book) caused by the progressive impairment or deterioration of neurons (nerve cells) in an area of the brain known as the substantia nigra. When functioning normally, these neurons produce a vital brain chemical known as dopamine. Dopamine serves as a chemical messenger allowing communication between the substantia nigra and another area of the brain called the corpus striatum. This communication coordinates smooth and balanced muscle movement. A lack of dopamine results in abnormal nerve functioning, causing a loss in the ability to control body movements. Neurophysical Disorders

• Parkinson’s Disease – Why Parkinson’s occurs and how the neurons become impaired is not known. However, increasing evidence suggests that it may be inherited. TREATMENTS: *Medical model: *Psychoanalysis: *Learning Theories: *Behaviorists: *Cognitive Therapies: irrational interpretations *Humanistic: client-centered therapies, responsibility, active-listening. Show THE WORLD OF AbNORMAL PSYCHOLOGY #10 Organic Brain Disorders SUBSTANCE ABUSE DISORDERS

1) ALCOHOL 2) COCAINE 3) METHALAMPHETAMINES 4) NICOTINE

Substance Abuse Disorders

1) Alcohol (Ch 7, p.294-304) *Drinking impairs life adjustments *Health, personal relationships, occupational functioning *Strong relationship between alcohol & violence.

Am I drinking too much? YES, if you are: ･A woman who has more than seven drinks* per week or more than three drinks per occasion ･A man who has more than 14 drinks* per week or more than four drinks per occasion ･Older than 65 years and having more than seven drinks* per week or more than three drinks per occasion *--One drink = one 12-oz bottle of beer (4.5 percent alcohol) or one 5-oz glass of wine (12.9 percent alcohol) or 1.5 oz of 80- proof distilled spirits. Substance Abuse Disorders

QuickTime™ and a 2) Cocaine (Ch 7, p.294-304) TIFF (Uncompressed) decompressor are needed to see this picture. *Chronic abuse can promote acute psychotic symptoms & hallucinations

QuickTime™ and a *Activates the part of the brain as areas TIFF (Uncompressed) decompress or are needed to see this picture. of pleasure & rewards (food, sex, water) *Long term effects include: Addiction Irritability and mood disturbances QuickTime™ and a TIFF (Uncompressed) decompress or Restlessness are needed to see this picture. Paranoia Auditory hallucinations QuickTime™ and a TIFF (Uncompressed) decompressor are needed to see this picture.

QuickTime™ and a TIFF (Uncompressed) decompressor are needed to see this picture. Substance Abuse Disorders

3) Methamphetamines

QuickTime™ and a *synthetic amphetamines or stimulants TIFF (Uncompressed) decompress or that are produced and sold illegally in pill are needed to see this picture. form, capsules, powder and chunks.

*has a structure similar to dopamine (the brain's pleasure transmitter) and causes neurons to release large amounts of dopamine to produce a high. ……… leads to permanent brain damage

QuickTime™ and a TIFF (Uncompressed) decompressor as natural dopamine production sites are are needed to see this picture. destroyed - forcing the user to become even more reliant on meth for pleasure.

*known as meth, crank, glass, speed,

QuickTime™ and a crystal, ice, batu, chalk, shabu, or zip TIFF (Uncompressed) decompressor are needed to see this picture. Substance Abuse Disorders

4) Nicotine (Ch 7, p.294-304) *Poisonous substance in cigarettes

*450,000 related deaths per year.

**Used as a coping device TREATMENTS: *Medical model: *Psychoanalysis: *Learning Theories: *Behaviorists: *Cognitive Therapies: irrational interpretations *Humanistic: client-centered therapies, responsibility, active-listening. Show

THE WORLD OF AbNORMAL PSYCHOLOGY: #6 Substance Abuse Disorders

The Meth Epidemic

Psych in Film, Ver 2, #25, Lost Weekend (alcoholism) SEXUAL DISORDERS

1) GENDER IDENTITY DISORDER (TRANSSEXUALISM) 2) SEXUAL DISFUNCTION 3) PARAPHILIAS

Sexual Disorders (Ch 12, p.467-482)

1) Gender Identity Disorder (Transsexualism) *Confusion or uncertainty between biological sex and gender identity.

2) Sexual Disfunction *Inhibitions in sexual response Sexual Disorders

3) Paraphilias – Fetishism, zoophilia, pedophila, exhibitionism, voyeurism, masochism, sadism et. al. – Sexual response to unusual objects or situations TREATMENTS: *Medical model: *Psychoanalysis: *Learning Theories: classical conditioning. *Behaviorists: *Cognitive Therapies: irrational interpretations *Humanistic: client-centered therapies, responsibility, active-listening. Show

THE WORLD OF AbNORMAL PSYCHOLOGY: #7 Sexual Disorders

DEVELOPMENTAL (CHILDHOOD) DISORDERS

1) ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD) 2) CONDUCT DISORDER 3) SEPARATION ANXIETY DISORDER 4) AUTISM 5) DYSLEXIA

1) Attention Deficit Hyperactivity Disorder (ADHD) (not in book) *Maladaptive behavior that interferes with effective task-oriented behavior *Impulsively, excessive motor activity, exaggerated muscular activity, difficulty maintaining attention *controversial diagnosis *Critics claim ADHD is overdiagnosed (i.e.)blame children for unskilled parents or teachers. *drug treatment includes stimulants *stimulant drug therapy combined with behavioral therapy can improve attention and diminished hyperactivity in 70% of ADHD children.

*Strattera -- a drug used for ADHD is a norepinephrine retake inhibitor 2) Conduct Disorders (not in book) *Persistant, repetitive violation of rules and disregard for rights of others *Fighting, defiance, disobedience, destruction of property, attention seeking, inattentiveness, over- aggressive behavior, bullying, physical aggression, cruel behavior toward people and pets, destructive behavior, lying, truancy, vandalism, and stealing. *ODD--Oppositional Defiant Disorder: disobedient, hostile behavior towards authority figures *clinically significant impairment in social, academic, or occupational functioning. 3) Separation Anxiety Disorder (not in book) *Excessive anxiety about separation from people to whom the child is attached *Unrealistic fears, oversensitivity, self- consciousness, nightmares, chronic anxiety 4) Autism (p. 147-148, 424, 668) *Pervasive developmental disorder occurring in infancy or childhood *Qualitative impairment in reciprocal social interaction & communication--restricted repertoire of activities & interests

Example: Sally and Ann are playing together, when Sally puts a piece of candy in a box and leaves the room. While Sally is gone, Anne opens the box, removes the candy and stashes it in her purse. When Sally comes back, where will she look for the candy? Normal children will say that Sally will look in the box. Autistic children are most likely to say (if they communicate at all) that Sally will look in the purse. The autistic child lacks “theory of mind”. Severely autistic children cannot imagine themselves in Sally’s place. 5) Dyslexia *reading difficulties *affects 1 of 5 children *involves the abnormalities in the brain’s language-processing circuits.

Another cause may be language itself: *English: bizarre spelling menagerie, containing 1120 ways to spell only 40 different sounds, are more likely to be dyslexic than *Italian: 33 combinations of letters for 25 sounds. TREATMENTS: *Medical model: Stimulants (ADHD) *Psychoanalysis: *Learning Theories: Token Economy *Behaviorists: *Cognitive Therapies: irrational interpretations *Humanistic: client-centered therapies, responsibility, active-listening. Show

THE WORLD OF AbNORMAL PSYCHOLOGY: #11 Behavior Disorders of Childhood

Psych in Film, Ver 2, #26, Mercury Rising (autism), #20, Sixteen Candles, #21, Snow Falling on Cedars (cross- cultural), #15, Parenthood (special needs child) ADJUSTMENT DISORDERS ADJUSTMENT DISORDERS: Other conditions that may be a focus of clinical attention.

*mild depression *physical complaints *marital problems *academic problems *job problems *parent-child problems *bereavement *malingering (faking an illness) TREATMENTS: *Medical model: *Psychoanalysis: *Learning Theories: *Behaviorists: *Cognitive Therapies: irrational interpretations *Humanistic: client-centered therapies, responsibility, active-listening. TREATMENTS: *Medical model: *Psychoanalysis: *Learning Theories: *Behaviorists: *Cognitive Therapies: irrational interpretations *Humanistic: client-centered therapies, responsibility, active-listening. SHOW Psych in Film, ver 2, #28, American Werewolf in London (sleep disorders) Questions for Review 1) RECALL In Rosenhan’s study, who discovered that the “pseudopatients” were feigning mental illness? a) psychiatrists b) psychologists c) Nurses and aides working on the ward d) Other patients e) Other physicians

2) APPLICATION Which of the following symptoms most clearly suggests the presence of abnormality? a) hallucinations b) worries c) Unusual behavior d) creativity e) distraction

3) RECALL Hippocrates proposed that mental disorder was caused by a) Possession by demons b) An imbalance in four bodily fluids c) A fungus growing on rye grain d) Traumatic memories in the unconscious e) The taking of potions.

4) RECALL The behavioral perspective emphasizes the influence of __, while the cognitive perspective emphasizes __. a) Genetics / conscious processes b) Conscious processes / unconscious processes c) Heredity / environment d) Medical factors / psychological factors e) The environment / mental process

5) UNDERSTANDING THE CORE CONCEPT Which of the following would be least likely to be noticed by a clinician using strictly the medical model of mental disorder? a) delusions b) Severe disturbances in affect c) An unhealthy family environment d) A degenerative brain disease e) hallucinations

6) RECALL The DSM IV is based on the a) Cognitive perspective b) Behavioral perspective c) Eclectic view d) Psychoanalytic view e) medical model

7) RECALL Which disorder involves extreme swings of mood from elation to depression? a) Panic disorder b) Bipolar disorder c) schizophrenia d) Unipolar depression e) PTSD

8) APPLICATION According to the preparedness hypothesis, which one of the following phobias would you expect to be most common? a) Fear of snakes (ophidiophobia) b) Fear of books (bibliophobia) c) Fear of horses (equinophobia) d) Fear of the number 13 (triskaidekaphobia) e) Fear of water (aquaphobia)

9) RECALL Which of the following disorders involves a deficiency in memory? a) phobia b) Antisocial personality c) Dissociative fugue d) obsessive-compulsive diorder e) schizophrenia

10) RECALL Which of the following is a disorder in which the individual displays more than one distinct personality? a) schizophrenia b) Depersonalization disorder c) Bipolar disorder d) phobia e) Dissociative identity disorder

11) RECALL Which of the following is primarily a disorder of young American women? a) Bipolar disorder b) schizophrenia c) Anorexia nervosa d) Antisocial personality disorder e) Dissociative identity disorder

12) RECALL Hallucinations and delusions are symptoms of a) schizophrenia b) Somatoform disorders c) Anxiety disorders d) Depersonalization disorders e) Panic disorders

13) RECALL Which category of disorder is most common? a) schizophrenia b) Dissociative disorder c) Eating disorders d) The adjustment disorders and “other conditions that may be a focus of clinical attention” e) Mood disorders

14) UNDERSTANDING THE CORE CONCEPT The DSM-IV groups most mental disorders by their a) treatments b) causes c) symptoms d) theoretical basis e) cures

15) UNDERSTANDING THE CORE CONCEPT Which unfortunate consequence of diagnosing mental disorders is emphasized chapter? a) The inaccuracy of diagnosis b) Stigmatizing those with mental disorders c) Adding to the already overcrowded conditions in mental hospitals d) That some cultures do not recognize mental disorders e) The importance of the insanity defense.

16) RECALL Which one of the following statements is true? a) Mental disorders have a similar prevalence in all cultures b) In general, biology creates mental disorder, while culture merely shapes the way a person experiences it. c) Culture-specific stressors occur primarily in developing countries d) Cultures around the world seem to distinguish between people with mental disorders and people who are visionaries or prophets. e) Mental disorders are more prevalent in Eastern culture.

17) RECALL Insanity is a) Psychological term b) Psychiatric term, found in DSM-IV under “psychotic disorders.” c) Legal term d) Term that refers either to “neurotic” or “psychotic” symptoms e) A classification for those seeking treatment.

18) RECALL A long-standing pattern of irresponsible behavior that hurts others without causing feelings of guilt or remorse is typical of a) An obsessive-compulsive disorder b) An antisocial personality disorder c) A narcissistic personality disorder d) Paranoid schizophrenia e) Dissociative fugue.

19) APPLICATION A young woman wanders into a hospital, claiming not to know who she is, where she is from, or how she got there. Her symptoms indicate that she might be suffering from a(n) ____ disorder a) anxiety b) affective c) personality d) dissociative e) mood

20) RECALL ____ has been called the “common cold of psychopathology” because it occurs so frequently and because almost everyone has experienced it, at least briefly, at some time. a) Obsessive-compulsive disorder b) Bipolar disorder c) Depression d) Paranoid schizophrenia e) Autism

21) RECALL A person who suffers from ____ cannot eat normally but engages in a ritual of “binging”--periodic binges of overeating--followed by “purging” with induced vomiting or use of laxitives. a) Anorexia nervosa b) Bulimia nervosa c) Inhibition d) Mania e) Depression

22) RECALL The ____ type of schizophrenia is characterized by delusions. a) residual b) catatonic c) paranoid d) undifferentiated e) disorganized

23) RECALL Rosenhan believes that his “pseudopatients” were not recognized as normal because a) The staff members in the mental hospital were incompetent b) The staff members in the mental hospitals were just as disturbed as the patients c) Mental illness is a myth d) Staff members did not expect patients to be normal e) He denied the existance of psychological disorders

24) MATCHING a) Hallucinations f) Somatoform disorders b) Delusions g) Dissociative disorders c) Medical model h) Diathesis-stress hypothesis d) Mood disorders i) Borderline personality disorder e) Anxiety disorders j) Autism

____ExtremeB disorders of thinking, involving persistent false beliefs.

25) MATCHING a) Hallucinations f) Somatoform disorders b) Delusions g) Dissociative disorders c) Medical model h) Diathesis-stress hypothesis d) Mood disorders i) Borderline personality disorder e) Anxiety disorders j) Autism

_____AJ developmental disorder marked by disabilities in language and social interaction.

26) MATCHING a) Hallucinations f) Somatoform disorders b) Delusions g) Dissociative disorders c) Medical model h) Diathesis-stress hypothesis d) Mood disorders i) Borderline personality disorder e) Anxiety disorders j) Autism

_____D A class of disorders including bipolar disorder.

28) MATCHING a) Hallucinations f) Somatoform disorders b) Delusions g) Dissociative disorders c) Medical model h) Diathesis-stress hypothesis d) Mood disorders i) Borderline personality disorder e) Anxiety disorders j) Autism

_____E A class of disorders including panic disorder.

29) MATCHING a) Hallucinations f) Somatoform disorders b) Delusions g) Dissociative disorders c) Medical model h) Diathesis-stress hypothesis d) Mood disorders i) Borderline personality disorder e) Anxiety disorders j) Autism

_____I A disorder characterized by an unstable personality given to impulsive behavior for which includes remorse after the fact.

30) MATCHING a) Hallucinations f) Somatoform disorders b) Delusions g) Dissociative disorders c) Medical model h) Diathesis-stress hypothesis d) Mood disorders i) Borderline personality disorder e) Anxiety disorders j) Autism

_____G A class of disorders including depersonalization disorder.

31) MATCHING a) Hallucinations f) Somatoform disorders b) Delusions g) Dissociative disorders c) Medical model h) Diathesis-stress hypothesis d) Mood disorders i) Borderline personality disorder e) Anxiety disorders j) Autism

_____F A class of disorders including conversion disorder.

32) MATCHING a) Hallucinations f) Somatoform disorders b) Delusions g) Dissociative disorders c) Medical model h) Diathesis-stress hypothesis d) Mood disorders i) Borderline personality disorder e) Anxiety disorders j) Autism

_____A False sensory experiences that may suggest a mental disorder.

33) MATCHING a) Hallucinations f) Somatoform disorders b) Delusions g) Dissociative disorders c) Medical model h) Diathesis-stress hypothesis d) Mood disorders i) Borderline personality disorder e) Anxiety disorders j) Autism

_____C The view that mental disorders are diseases that have objective physical causes and require specific treatments.

34) MATCHING a) Hallucinations f) Somatoform disorders b) Delusions g) Dissociative disorders c) Medical model h) Diathesis-stress hypothesis d) Mood disorders i) Borderline personality disorder e) Anxiety disorders j) Autism

_____H The proposal that genetic factors place the individual at risk while environmental stress factors transform this potential into schizophrenic disorder.

Show #21, Zimbardo, Psychopathology