⚫ The World Health Organization reports that, worldwide, some 450 million people suffer from mental or behavioral disorders.
⚫ What is the term INSANE?
1. Is it maladaptive and/or disturbing to the individual? 2. Is it disturbing to others?
3. It is unusual – not shared by many members of the
4. It is irrational? (Does not seem to make sense to the
⚫ How have the mentally ill been treated throughout human history?
Philippe Pinel Dorothea Dix
⚫ Advocated to for human treatment of the mentally ill. ⚫ Insisted madness was not demon possession, but a
sickness of the mind caused by severe stresses and inhumane treatment.
⚫ Pinel (1745-1826) France
⚫ Dorothea Dix – (1800’s) America
⚫ The concept that diseases have physical causes that can be diagnosed, treated, and inmost causes, cured, often
through treatment in a hospital
⚫ 1. to describe a disorder
⚫ 2. to predict its future course
⚫ 3. to find appropriate treatment
⚫ 4. to stimulate research into its causes
⚫ American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Addition (2013).
⚫ A widely used system for classifying and diagnosing psychological disorders.
⚫ The DSM contains the symptoms of everything currently considered to be a psychological disorder.
⚫ The DSM does not include much discussion about the
causes of disorders because each psychological perspective disagrees.
⚫ Based on assessments, interviews, and observations, many clinicians diagnose by answering the questions posed by the five levels – or axes – of the DSM –IV-TR
⚫ 83% in agreement in studies of multiple doctors’ diagnoses
How are Psychological Disorders
⚫ See page 566 for Axis Questions:
⚫ Axis I – Is a Clinical Syndrome present?
⚫ Axis II – Is a Personality Disorder or Intellectual Disability Present
⚫ Axis III – Is a General Medical Condition, such as diabetes, hypertension, or arthritis, also present?
⚫ Axis IV – Are Psychosocial Environmental Problems, such as school or housing issues, also present?
⚫ Axis V – What is the Global Assessment of this person’s functioning? (Code from 0-100)
This axis describes
cause significant impairment.
Disorders are grouped into different categories.
This axis describes long-term problems that are overlooked in the presence of Axis I disorders.
⚫ Personality disorders cause significant problems in how a patient relates to the world.
⚫ Mental retardation is characterized by intellectual
impairment and deficits in other areas such as self-care and interpersonal skills.
These include physical and medical conditions that may influence or worsen Axis 1 and Axis II disorders. Some examples may include HIV/AIDS and brain injuries.
Any social or environmental problems that may impact Axis I or Axis II disorders are accounted for in this
⚫ These may include such things as unemployment, relocation, divorce, or the death of a loved one.
This axis allows the clinician to rate the client's overall level of functioning. Based on this assessment, clinicians can better understand how the other four axes are
interacting and the effect on the individual's life.
⚫ David Rosehan 1973 study
⚫ Biases and Self-fulfilling prophecies
⚫ Patterns of thoughts, feelings, or behaviors that are deviant, distressful, and dysfunctional.
⚫ Standards of deviant behavior vary by context, culture, and time
For example, from 1952-1973, homosexuality was classified as mental illness
⚫ Psychological disorders characterized by distressing, persistent anxiety or maladaptive behaviors that reduce anxiety.
⚫ Generalized Anxiety Disorder ⚫ Panic Disorder
⚫ Obsessive-compulsive disorder
⚫ Post-traumatic stress disorder (PTSD)
⚫ An anxiety disorder in which a person is continually tense, apprehensive, and in a state of autonomic nervous system arousal.
⚫ The person is unexplainably tense and uneasy ⚫ Jittery, headaches, fidgety, twitches, perspiration
⚫ Often mellow with time, by age 50 GAD becomes rare
⚫ Unpredictable minutes-long episodes of intense dread in which a person experiences terror and accompanying chest pain, choking, or other, frightening sensations.
⚫ Sudden episodes of intense dread
⚫ A persistent, irrational fear and avoidance of a specific object, activity, or situation.
⚫ What is the difference between a phobia and a fear?
Obsessive Compulsive Disorder
⚫ An anxiety disorder characterized by unwanted repetitive thoughts (obsessions) and/or actions (compulsions)
⚫ Interfere with everyday living and cause the person distress.
⚫ Learning Principles – Classical and Operant Conditioning ⚫ Can become negatively reinforced (take away bad) –
oftentimes the behavior takes anxiety away. Then these behaviors become repeated.
⚫ OCD used to be classified as an anxiety disorder, but now has a separate classification in the DSM-5.
⚫ Hording and body dismorphic disorder or classified as related disorders under this new category.
⚫ Haunting memories, nightmares, social withdrawal, jumpy anxiety, and/or insomnia that lingers for four weeks or
more after a traumatic experience.
⚫ Often affects veterans but it can affect anyone who has experienced trauma.
⚫ Used to be called “shellshock” or “battle fatigue” for soldiers
⚫ PTSD was once classified as an anxiety disorder, but the DSM-5 moved it to a group of trauma and stressor-related disorders.
⚫ Learning Perspective ⚫ Observational Learning ⚫ Natural Selection
What are somatoform disorders?⚫ A psychological disorder in which the symptoms take a
somatic (bodily) form without apparent physical cause.
⚫ Conversion Disorder
⚫ Hypochondriasis – (Under the DSM-5, these symptoms are diagnosed as a somatic symptom disorder if the person reports concern with symptoms. If the person is very
⚫ A rare somatoform disorder in which a person experiences very specific genuine physical symptoms for which no
physiological basis can be found.
⚫ Anxiety is converted to physical symptoms
⚫ Paralysis, blindness, inability to swallow, loss of voice.
⚫ A somatoform disorder in which a person interprets normal physical sensations as symptoms of a disease. ⚫ Relatively common disorder
⚫ Disorders in which conscious awareness becomes separated (dissociated) from previous memories, thoughts, and feeling.
⚫ Disorders of consciousness
⚫ Sudden loss of memory or loss of memory, oftentimes due to overwhelming stress.
⚫ World Trade Center Story
⚫ Brings up “Repression” argument
⚫ Dissociation is not rare (daydreaming and hypnosis) this it not the same as a dissociative disorder
⚫ Psychogenic amnesia – cannot remember things and no physiological cause.
⚫ Organic amnesia – cannot remember things but there is a physiological cause
⚫ Fugue – experience psychogenic amnesia and find themselves in an unfamiliar environment.
⚫ A rare dissociative Disorder in which a person exhibits two or more distinct and alternating personalities.
⚫ Formerly called multiple personality disorder.
⚫ Own voice, handwriting, mannerisms
⚫ Even different brain scans and eye muscle balance
⚫ Most of the time, the original personality denies awareness of other personalities.
⚫ Kenneth Bianchi “Hillside Strangler” (1980’s) (Liar)
⚫ Too localized in time and space
⚫ Only found in US from 19303 – present day
⚫ Psychological disorders characterized by emotional extremes.
⚫ Major Depressive Disorder ⚫ Mania
⚫ Bipolar Disorder (Manic Depression)
⚫ Dysthymic – (similar to major depression but less intense) ⚫ Seasonal affect Disorder (SAD)
⚫ A mood disorder in which a person experiences, in the absence of drugs or a medical condition, two or more weeks of significantly depressed moods, feelings of
worthlessness, and diminished interest or pleasure in most activities.
⚫ “Common Cold” of psychological disorders ⚫ #1 reason people seek mental health services
⚫ Per year – 5.8% men and 9.5% women report depression worldwide each year.
⚫ A mood disorder marked by a hyperactive, wildly optimistic state.
⚫ If depression is living in slow motion, mania is living in fast forward.
⚫ 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
⚫ More dysfunctional than major depressive disorder
⚫ Can be incredibly productive during manic phase
⚫ Composers, artists, poets, and novelists, are especially prone to bipolar disorder
⚫ Whitman, Dickenson, Twain, Hemingway ⚫ Afflicts men and women equally
⚫ Stressful Life Events ⚫ Cognitive Changes ⚫ Behavioral Changes
⚫ The Depressed Brain ⚫ The Manic Brain
⚫ Biochemical Influences - Neurotransmitters
⚫ A group of severe disorders characterized by disorganized and delusional thinking, disturbed perceptions, and
inappropriate emotions and actions.
⚫ Literally means “Split mind” – which is a split from reality.
⚫ “If depression is the common cold, schizophrenia is the cancer.”
⚫ Nearly 1 and 100 people will develop schizophrenia – 24 million worldwide.
⚫ Disorganized thinking ⚫ Disturbed perceptions
⚫ Inappropriate emotions and actions
⚫ Delusions – false beliefs, often of persecution or
grandeur, that may accompany psychotic disorders.
⚫ Hallucinations – sensory experiences without sensory stimulation) feeling, seeing, tasting, smelling things that are not there
⚫ Often use odd language:
⚫ Neologisms – made up words
⚫ Clang associations – string together a series of nonsense words
⚫ Inappropriate Affect:
⚫ Example, might laugh when they hear sad news
⚫ Flat affect – no emotion
⚫ May be catatonic with waxy flexibility
Schizophrenia Continued⚫ Positive Symptoms:
Hallucinations, delusions, (outward things we see)
⚫ Negative Symptoms :
⚫ Paranoid –preoccupied with delusions or hallucinations
⚫ Disorganized – disorganized speech or behavior
⚫ Catatonic - immobility or excessive purposeless movements;
⚫ Undifferentiated – Many varied symptoms
⚫ Residual – withdrawal, after hallucinations and delusions have disappeared.
⚫ - Brain Abnormalities
⚫ - Neurotransmitters - Dopamine ⚫ - Genetics
⚫ - Onset ⚫ - Flu
⚫ - Drug Therapy
⚫ - Nicotine – (60% of all schizophrenics smoke)
⚫ Psychological Disorders characterized by inflexible and enduring behavioral patterns that impair social functioning.
⚫ Narcissistic Personality Disorder ⚫ Histrionic Personality Disorder ⚫ Borderline Personality Disorder ⚫ Antisocial Personality Disorder
Narcissistic Personality Disorder
Histronic Personality Disorder
⚫ Inappropriate or extreme emotional reactions. ⚫ Highly impulsive behaviors.
⚫ A history of unstable relationships.
⚫ Paranoid personality disorder
⚫ Dependent personality disorder
⚫ Obsessive-compulsive personality disorder
⚫ A personality disorder in which the person (usually a man) exhibits a lack of consciousness for wrongdoing, even
towards friends and family members.
⚫ May be aggressive and ruthless or a clever con artist.
⚫ Most troubling and heavily researched personality disorder.
⚫ Formerly called a sociopath or a psychopath
⚫ Typically male
⚫ Onset before a 15
⚫ May Lie, steal, fight, rape, and/or murder
⚫ Feel little fear or empathy – even as small children ⚫ Do not feel guilt or remorse
⚫ “I think of killing like smoking a cigarette, like another habit.”
⚫ Reduced activity in frontal lobe ⚫ Less tissue in frontal lobe
⚫ Seems genetic
⚫ 5-6% of offenders commit 50-60% of all crimes,
⚫ Eating disorders – i.e., anorexia nervosa, bulimia, obesity ⚫ Substance related and addictive disorders
⚫ Paraphilas or psychosexual disorders – pedophilia, zoophilia, fetishism, voyeur, masochist, sadist
⚫ Neurodevelopment disorders – i.e., autism, attention deficit disorder
⚫ Neurocognitive disorders – most famous = Alzheimer’s disease.
⚫ Autism - Seek out less social involvement and emotional contact
⚫ Psychogenic Amnesia ⚫ Fugue
⚫ Seasonal Affective Disorder ⚫ Dysthymic Disorder
⚫ Cognitive Triad ⚫ Waxy Flexibility ⚫ Tardive Dyskinesia ⚫ Diathesis-stress model
⚫ Dependent Personality Disorder ⚫ Paranoid Personality Disorder ⚫ Autism
⚫ Attention Deficit/hyperactivity disorder