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31

Lesson PLanning CaLendar

Use this Lesson Planning Calendar to determine how much time to allot for each topic.

Schedule Day One Day TwoTraditional Period (50 minutes) Anxiety Disorders Mood Disorders

Block schedule (90 minutes) Anxiety Disorders

Mood Disorders

Anxiety and Mood Disorders

548a

B2E3e_book_ATE.indb 1 3/19/12 10:51 AM

31aCTiviTy PLanner From The TeaCher’s resourCe maTeriaLs

Use this Activity Planner to bring active learning to your daily lessons.

Topic Activitiesanxiety disorders Getting Started: Critical Thinking Activity: Fact or Falsehood? (10 min.)

Digital Connection: Scientific American Frontiers (2nd ed.), Segment 32: “Arachnophobia” (10 min.)

Analysis Activity: Taylor Manifest Anxiety Scale (15 min.)

Application Activity: Fear Survey (15 min.)

Analysis Activity: Social Phobias (15 min.)

Analysis Activity: Obsessive- Compulsive Disorder (15 min.)

Building Vocabulary/Graphic Organizer: Concept Web (15 min.)

Digital Connection: The Mind (2nd ed.), Module 32: “Mood Disorders: Hereditary Factors” (10 min.)

Enrichment Lesson: Concentration Camp Survival (15 min.)

Enrichment Lesson: Obsessive Thoughts (15 min.)

Digital Connection: DVD: Anxiety-RelatedDisorders(15 min. each)

Digital Connection: DVD: As Good as It Gets(139 min.)

Digital Connection: DVD: Obsessive-CompulsiveDisorder:AnAlternativeTreatment(15 min.)

Digital Connection: DVD: Post-TraumaticStressDisorder(28 min.)

mood disorders Digital Connection: The Mind (2nd ed.), Module 31: “Mood Disorders: Mania and Depression” (10 min.)

Application Activity: The Zung Self- Rating Depression Scale (20 min.)

Analysis Activity: The Automatic Thoughts Questionnaire (20 min.)

Critical Thinking Activity: Depression and Memory (20 min.)

Critical Thinking Activity: The Revised Facts on Suicide Quiz (20 min.)

Analysis Activity: The Body Investment Scale and Self- Mutilation (20 min.)

Analysis Activity: Loneliness (20 min.)

Enrichment Lesson: Cognitive Errors in Depression (15 min.)

Digital Connection: DVD Series: No More Shame:UnderstandingSchizophrenia,Depression,andAddiction(21 min. each)

Digital Connection: DVD: Depression:BeatingtheBlues(28 min.)

Enrichment Lesson: Postpartum Depression (15 min.)

Enrichment Lesson: The Sadder- but- Wiser Effect (15 min.)

Enrichment Lesson: Self- Mutilation (15 min.)

Enrichment Lesson: Commitment to the Common Good (15 min.)

Portfolio Project: Exploring Psychological Disorders on the World Wide Web

548b

MODULE 31


This module covers two of the most common categories of psychological disorders— anxiety disorders and mood disorders. There is little doubt that you know individuals who struggle mightily with problems related to anxiety and mood. If you are “normal,” you have probably struggled occasionally with such problems yourself.

An odd and sometimes troubling aspect of psychological disorders is that it’s easy to see the symptoms— almost all the symptoms— in yourself. The symptoms of psychological disorders usually fall along a continuum. They can be mild, serious, or anything between. Typically, there is a “gray area” where it’s difficult to decide whether there is a significant problem. This is different from many medical conditions that are more likely to be either present or absent, with nothing between. It doesn’t make sense to talk about a woman being kind of pregnant, but it is surely possible to be sort of anxious.

So, I’m going to give you the warning I was given years ago: Don’t overreact if you begin to discover in yourself the symptoms we discuss in this module. That’s typical, and there’s even a name for it— “psychology student’s disease.” The point

Anxiety Disorders● Generalized Anxiety

Disorder and Panic Disorder

● Phobia● Obsessive- Compulsive

Disorder● Post- Traumatic Stress

Disorder● Causes of Anxiety

Disorders

Mood Disorders● Major Depressive

Disorder● Bipolar Disorder● Causes of Mood

Disorders

Are you scared of snakes? Spiders? Maybe for you it’s heights or crowds. Almost all of us feel anxious under some circumstances, and we also experience a vari-ety of moods in our daily lives. When these normal reactions make it difficult to function, we have anxiety or mood disorders. They are among the most common psychological disorders of all.

549


549

31

resource managerActivities TE Web/Multimedia TE Film/Video TEAnalysis 550, 551, 552, 553, 555, 561, 563 Digital Connection 553 Anxiety-RelatedDisorders 550

Application 551, 552, 557, 559, 560 Scientific American Frontiers (2nd ed.), Segment 32 552

Critical Thinking 549, 562, 563, 567 As Good as It Gets 554

Enrichment 555, 556, 560, 561, 563, 564, 565 Obsessive-CompulsiveDisorder:AnAlternativeTreatment 554

Graphic Organizer 549, 551 Post-TraumaticStressDisorder 555

Portfolio Project 567 The Mind (2nd ed.), Module 32 557

Vocabulary 549, 551 The Mind (2nd ed.), Module 31 559

NoMoreShame:UnderstandingSchizophrenia,Depression,andAddiction

559

Depression:BeatingtheBlues 559

inTroduCe The moduLe

Getting Started TRMHave students consider the following questions:

● What does it mean to be anxious? What behaviors do anxious people exhibit?

● How many different moods do peo-ple normally experience in a day?

You may wish to use Critical Thinking Activity: Fact or False-hood? as a prereading strategy to evaluate what students already know about anxiety and mood disorders. The activity, along with its results, will prime students to note terms and concepts in the text that confirm or dispel their preconceptions about these disorders.

Building Vocabulary TRMStudents can complete Building Vocabulary/Graphic Organizer: Concept Web to help them learn the terms in this module and understand the relationships among them.

r m

Getting StartedHave students consider the following questions:

●

●

Thinkinghood?evaluate what students already know about anxiety and mood disorders. The activity, along with its results, will prime students to note terms and concepts in the text that confirm or dispel their preconceptions about these disorders.

Building Vocabulary Students can complete Vocabulary/Graphic Organizer: Concept Webterms in this module and understand the relationships among them.

MODULE 31


This module covers two of the most common categories of psychological disorders— anxiety disorders and mood disorders. There is little doubt that you know individuals who struggle mightily with problems related to anxiety and mood. If you are “normal,” you have probably struggled occasionally with such problems yourself.

An odd and sometimes troubling aspect of psychological disorders is that it’s easy to see the symptoms— almost all the symptoms— in yourself. The symptoms of psychological disorders usually fall along a continuum. They can be mild, serious, or anything between. Typically, there is a “gray area” where it’s difficult to decide whether there is a significant problem. This is different from many medical conditions that are more likely to be either present or absent, with nothing between. It doesn’t make sense to talk about a woman being kind of pregnant, but it is surely possible to be sort of anxious.

So, I’m going to give you the warning I was given years ago: Don’t overreact if you begin to discover in yourself the symptoms we discuss in this module. That’s typical, and there’s even a name for it— “psychology student’s disease.” The point

Anxiety Disorders● Generalized Anxiety

Disorder and Panic Disorder

● Phobia● Obsessive- Compulsive

Disorder● Post- Traumatic Stress

Disorder● Causes of Anxiety

Disorders

Mood Disorders● Major Depressive

Disorder● Bipolar Disorder● Causes of Mood

Disorders

Are you scared of snakes? Spiders? Maybe for you it’s heights or crowds. Almost all of us feel anxious under some circumstances, and we also experience a vari-ety of moods in our daily lives. When these normal reactions make it difficult to function, we have anxiety or mood disorders. They are among the most common psychological disorders of all.

549


550

31TeaCh

TeaChing TiP TRMRemind students that you and the counselors at your school are avail-able to talk about anything that might concern them as they study this and the successive modules. While students may begin to self- diagnose disorders in their own lives, they may also feel that friends and loved ones have these disorders. Develop a list of resource personnel you can refer students to for various issues they may want to discuss with a qualified professional.

At this point, you may want to watch Anxiety-Related Disorders.

Beyond the Classroom TRMBellringers Use the following prompts as discussion starters:

● Describe a time when you have been anxious. What situation made you anxious? What were you afraid of? How did you react to this anxiety?

● What causes you the most anxiety in general: school, family, friends, the future, or your work? Explain why.

At this point, you may want to use Analysis Activity: Taylor Manifest Anxiety Scale.

able to talk about anything that might

the successive modules. While students

that friends and loved ones have these

Use the following prompts

Describe a time when you have been

What causes you the most anxiety in

550 �� I n d I v I d u a l v a r I a t I o n s �� Psychological Disorders

to remember is that we all have some of these symptoms some of the time. But they don’t suggest a psychological disorder unless they meet four important criteria: symptoms must be maladaptive (disrupting normal functioning), unjustifiable, dis-turbing, and atypical. For most people most of the time, these symptoms do not meet these criteria. However, if you become concerned that you might be one of the many people affected by the psychological disorders we discuss in this module, you owe it to yourself to have it checked out. Talk to your parents or your guidance counselor for a referral to a mental health professional who can either lay your concerns to rest or help you resolve a problem if it does exist.

Now let’s take a look at the anxiety disorders and the mood disorders. These psy-chological disorders, like all others, are diagnosed according to the criteria estab-lished in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM- IV- TR) (2000). This guide identifies the symptoms that must be present for a diagnosis to be made.

Anxiety Disorders

WHAT’S THE POINT?

31-1 What are the anxiety disorders, and what causes them?

When psychologists speak of anxiety, they are referring to a vague feeling of apprehension and nervousness. You’ve probably experienced anxiety in relation to specific events— big tests, school projects, or important medical tests, for example. You may also have experienced a more general anxiety, such as feeling ill at ease about the changes that college or a new job might bring or concern about how troubling world events will play out. These are both normal types of feelings. Anxiety disorders differ from these feelings in that anxiety— or effort to control it— begins to take control and dominate life.

anxiety A vague feeling of apprehension or nervousness.

generalized anxiety disorder An anxiety disorder characterized by disruptive levels of persistent, unexplained feelings of appre-hension and tenseness.

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Anxiety

We all experience anxiety in our lives, often as a response to stressful events. Anxiety is not a disorder unless it begins to create significant difficul-ties in a person’s life.

Anxiety and Mood Disorders �� M o d u l e 3 1 �� 551

When this happens, quality of life suffers (Olatunji et al., 2007), and unhap-piness increases (Kashdan & Steger, 2006). We discuss five kinds of anxiety disorders (see Figure 31.1):

● Generalized anxiety disorder, marked by disruptive levels of persis-tent, unexplained feelings of apprehension and tenseness

● Panic disorder, marked by sudden bouts of intense, unexplained panic

● Phobia, marked by disruptive, irrational fears of objects, activities, or situations

● Obsessive- compulsive disorder (OCD), marked by unwanted, repeti-tive thoughts and actions

● Post- traumatic stress disorder (PTSD), characterized by reliving a severely upsetting event in unwanted, recurring memories and dreams

Generalized Anxiety Disorder and Panic DisorderUntil pharmaceutical companies began advertising drugs to combat general-ized anxiety disorder, many people had never heard of this condition. It doesn’t have the dramatic symptoms of many other psychological disorders and until recently had escaped public attention. The drug company advertisements probably leave many people uneasy because most of us have physical and psychological symptoms on occasion that characterize this disorder. How-ever, the symptoms are more lasting for those who suffer generalized anxiety

Figure 31.1

Anxiety Disorders

Anxiety is a major compo-nent in all anxiety disorders, although it is expressed dif-ferently in each disorder.

AnxietyDisorders

Post-Traumatic Stress Disorder

Recurrent memories and dreamsof traumatic event

Obsessive-Compulsive Disorder

Anxiety controlled byrepetitive thoughts

and behaviors

Phobia

Anxiety becoming afocused fear

Panic Disorder

Anxiety escalating tooverwhelming panic

Generalized Anxiety Disorder

Apprehension and tenseness

panic disorder An anxiety disorder characterized by sud-den bouts of intense, unex-plained anxiety, often associated with physical symptoms like choking sensations or shortness of breath.

phobia An anxiety disorder characterized by disruptive, irra-tional fears of objects, activities, or situations.

obsessive- compulsive disor-der (OCD) An anxiety disorder characterized by unwanted, repetitive thoughts and actions.

post- traumatic stress disorder (PTSD) An anxiety disorder characterized by reliving a severely upsetting event in unwanted, recurring memories and dreams.


551

31DifferentiationPatients who have generalized anxi-ety disorder (GAD) often also have major depression, an illness discussed later in this module. Effexor, a drug manufactured by Wyeth- Ayerst, has shown to be effective in treating both GAD and major depression. Paxil, an antidepressant drug in the same class as Prozac and Zoloft, is a sero-tonin reuptake inhibitor and is also approved for use to treat GAD as well as social phobia and panic disorder.

Differentiation TRMGraphic Organizer These options allow learners at all levels to complete Building Vocabulary/Graphic Orga-nizer: Concept Web.

● Independent learners can fill out the organizer on their own or follow along in class during discussion and lecture.

● Cooperative learners can use the textbook as a resource and work in groups to find the answers that fit in the blanks.

● Exceptional learners can fill in the blanks independently, with a tutor, or during class discussion and lecture.


● Have you ever had a panic attack? Describe the experience.

● What are some things that you have a legitimate reason to be afraid of? How did you develop that fear?

● What are some things that you have an irrational fear of? How did that fear develop?

At this point, you may want to use Application Activity: Fear Survey or Analysis Activity: Social Phobias.


to remember is that we all have some of these symptoms some of the time. But they don’t suggest a psychological disorder unless they meet four important criteria: symptoms must be maladaptive (disrupting normal functioning), unjustifiable, dis-turbing, and atypical. For most people most of the time, these symptoms do not meet these criteria. However, if you become concerned that you might be one of the many people affected by the psychological disorders we discuss in this module, you owe it to yourself to have it checked out. Talk to your parents or your guidance counselor for a referral to a mental health professional who can either lay your concerns to rest or help you resolve a problem if it does exist.

Now let’s take a look at the anxiety disorders and the mood disorders. These psy-chological disorders, like all others, are diagnosed according to the criteria estab-lished in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM- IV- TR) (2000). This guide identifies the symptoms that must be present for a diagnosis to be made.

Anxiety Disorders

WHAT’S THE POINT?


When psychologists speak of anxiety, they are referring to a vague feeling of apprehension and nervousness. You’ve probably experienced anxiety in relation to specific events— big tests, school projects, or important medical tests, for example. You may also have experienced a more general anxiety, such as feeling ill at ease about the changes that college or a new job might bring or concern about how troubling world events will play out. These are both normal types of feelings. Anxiety disorders differ from these feelings in that anxiety— or effort to control it— begins to take control and dominate life.

anxiety A vague feeling of apprehension or nervousness.

generalized anxiety disorder An anxiety disorder characterized by disruptive levels of persistent, unexplained feelings of appre-hension and tenseness.

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Anxiety

We all experience anxiety in our lives, often as a response to stressful events. Anxiety is not a disorder unless it begins to create significant difficul-ties in a person’s life.

DifferentiationPatients who have etymajor depression, an illness discussed later in this module. Effexor, a drug manufactured by Wyeth-shown to be effective in treating both GAD and major depression. Paxil, an antidepressant drug in the same class as Prozac and Zoloft, is a serotonin reuptake inhibitor and is also approved for use to treat GAD as well as social phobia and panic disorder.

Differentiation Graphic Organizerallow learners at all levels to complete Buildingnizer: Concept Web.

●

●

●

Beyond the Classroom Bellringersas discussion starters:

●

●

●

ApplicationAnalysis


When this happens, quality of life suffers (Olatunji et al., 2007), and unhap-piness increases (Kashdan & Steger, 2006). We discuss five kinds of anxiety disorders (see Figure 31.1):

● Generalized anxiety disorder, marked by disruptive levels of persis-tent, unexplained feelings of apprehension and tenseness

● Panic disorder, marked by sudden bouts of intense, unexplained panic

● Phobia, marked by disruptive, irrational fears of objects, activities, or situations

● Obsessive- compulsive disorder (OCD), marked by unwanted, repeti-tive thoughts and actions

● Post- traumatic stress disorder (PTSD), characterized by reliving a severely upsetting event in unwanted, recurring memories and dreams

Generalized Anxiety Disorder and Panic DisorderUntil pharmaceutical companies began advertising drugs to combat general-ized anxiety disorder, many people had never heard of this condition. It doesn’t have the dramatic symptoms of many other psychological disorders and until recently had escaped public attention. The drug company advertisements probably leave many people uneasy because most of us have physical and psychological symptoms on occasion that characterize this disorder. How-ever, the symptoms are more lasting for those who suffer generalized anxiety

Figure 31.1

Anxiety Disorders

Anxiety is a major compo-nent in all anxiety disorders, although it is expressed dif-ferently in each disorder.

AnxietyDisorders

Post-Traumatic Stress Disorder

Recurrent memories and dreamsof traumatic event

Obsessive-Compulsive Disorder

Anxiety controlled byrepetitive thoughts

and behaviors

Phobia

Anxiety becoming afocused fear

Panic Disorder

Anxiety escalating tooverwhelming panic

Generalized Anxiety Disorder

Apprehension and tenseness

panic disorder An anxiety disorder characterized by sud-den bouts of intense, unex-plained anxiety, often associated with physical symptoms like choking sensations or shortness of breath.

phobia An anxiety disorder characterized by disruptive, irra-tional fears of objects, activities, or situations.

obsessive- compulsive disor-der (OCD) An anxiety disorder characterized by unwanted, repetitive thoughts and actions.

post- traumatic stress disorder (PTSD) An anxiety disorder characterized by reliving a severely upsetting event in unwanted, recurring memories and dreams.


552

31Differentiation TRMAgoraphobia, the fear of being in open spaces or in public, often accom-panies panic disorder. Because people experience panic attacks at uncontrol-lable times and in uncontrollable situ-ations, they will often develop a fear of being out in public and having a panic attack. This fear leaves them suffering in their homes afraid to leave at all.

At this point, you may want to use Application Activity: Fear Survey.

Beyond the Classroom TRMAnalyze Phobias are one of the most successfully treated disorders around, yet few people with phobias seek treat-ment for them. Have students contem-plate why this might be.

● Why would people be reluctant to get treatment for their everyday fears? (Everyday fears might not be crippling or disruptive. Also, people may successfully avoid their fear object, not seeing the need to rid themselves of the fear.)

● What types of fears are more crip-pling than others? Why?

At this point, you may want to use Scientific American Frontiers (2nd ed.), Segment 32: “Arachnophobia.”

-

--

ations, they will often develop a fear of being out in public and having a panic attack. This fear leaves them suffering

yet few people with phobias seek treat--

ed.), Segment 32: “Arachnophobia.”


disorder and are often not attached to any specific event. Table 31.1 lists these symptoms. Individuals with generalized anxiety disorder must experience at least three of them.

Sometimes the anxiety is accompanied by panic attacks— episodes of unexplained terror and fear that something bad is going to happen. The panic attacks, which may last several minutes, usually involve such physical symp-toms as choking sensations or shortness of breath. Have you ever experienced panic? I can recall an episode when I was about 12 years old. My parents were out and I had watched a frightening show on television. Although I had no reason to do so, I became temporarily convinced that something horrible had happened to my parents. They were fine, of course, but the panic I expe-rienced was so intense that I still remember it clearly almost 50 years later.

We may all feel panic at some point in our lives, but imagine having these attacks several times each day. You’re sitting in class, trying to take notes, and the waves of fear start to wash over you for no apparent reason. Your ability to concentrate is destroyed; all your energy is directed toward trying to regain control. Such is the life of a person with panic disorder.

PhobiaAlmost everyone has heard the word phobia, which many people use to mean fear. (“I have a phobia about taking tests.”) To psychologists, however, a pho-bia is more than just a fear— it is a fear that is both irrational and disruptive. If you were being stalked on a dark street late at night, your fear of the stalker would not be irrational. But note that irrational fear alone is not enough to define phobia— the fear must also be disruptive. Most of us have irrational, nondisruptive fears— of harmless snakes or closed- in spaces, for example. My own particular irrational fear is the step from a ladder to a roof. Despite knowing that I can make the step safely, I hate it. I hate it to the extent that I have never been on the roof of the house in which I have lived for more than 20 years. If I were a roofer or a fireman, this fear would be disruptive. But I’m a teacher, and I seldom need to climb onto my roof. On those rare occasions when this becomes necessary, I simply have one of my sons do it or call some-one else to do the job. My fear is intense and irrational, but it’s not disruptive.

Table 31.1

Symptoms of Generalized Anxiety Disorder

Restlessness

Feeling on edge

Difficulty concentrating or mind going blank

Irritability

Muscle tension

Sleep disturbance

Source: Adapted from American Psychiatric Association (2000).

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Why are phobias considered anxiety disorders? Because they focus gen-eral feelings of anxiety onto a feared object, activity, or situation (see Figure

31.2). Most phobias involve fear of a particular object, and their names are formed by combining the Greek word for the object with phobia, which is the Greek word for “fear.” Fear of spiders, for example, is called arachnophobia. Broader phobias also occur.

Social phobias produce fear in social situations. For example, some people have extreme difficulty speaking in public, even to the extent of being unable to respond to questions from a clerk in a store. Others cannot eat in the pres-ence of others or use public restrooms. As you might imagine, social phobias can seriously impair a person’s ability to lead a normal life.

Agoraphobia is fear of situations the person views as difficult to escape from if panic begins to build. Many people with this disorder become trapped in their own homes or in similar safe zones. I once had dinner with a woman from my town who was recovering from agoraphobia. She was a middle- aged widow who lived by herself and could not leave her home without experienc-ing intense fear. She described to me the difficulty of ordinary tasks like gro-cery shopping, which was to her similar to a military commando raid. Only with intense planning and determination could she leave her car, quickly col-lect the two or three items she needed most, and make it through checkout before dashing back to her car. Often she began to feel panicky during her

25%

20

15

10

5

0

Percentageof peoplesurveyed

Beingalone

Storms Water Closespaces

Flying Blood Height AnimalsPhobia

Fear

Figure 31.2

Some Common— and Not- So- Common— Fears

A national survey identi-fied the percentage of people indicating various specific fears. (From Curtis et al., 1998.)

Ophidiophobia

Even a swashbuckler like Indiana Jones is not immune to psychological disorders, in this case a phobia of snakes.

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SurveyHave students conduct a study using Analysis Activity: Taylor Manifest Anxiety Scale and/or Application Activity: Fear Sur-vey. Students can even create their own survey to see what students in your school typically fear.

● Establish an institutional review board (IRB) composed of fellow teachers and admin-istrators who can review the experimental design to ensure all ethical standards are being followed.

● Be sure to obtain informed con-sent with each survey adminis-tered to conform with ethical standards.

● Have students write up their findings to publish in a high school journal or as a news item for the school’s news-paper. Be sure their report discusses anxiety based on well- researched facts.

Active LeArning TRM


553

31Beyond the ClassroomGuest Speaker Contact a psycholo-gist who specializes in treating anxiety disorders and ask about treatment options available to people who have this class of disorders.

● What types of medication are available?

● What types of behavioral or cogni-tive therapy are used?

● Do patients typically get completely rid of their fear through therapy, or is the goal of therapy to get patients to a comfortable level of functioning?


disorder and are often not attached to any specific event. Table 31.1 lists these symptoms. Individuals with generalized anxiety disorder must experience at least three of them.

Sometimes the anxiety is accompanied by panic attacks— episodes of unexplained terror and fear that something bad is going to happen. The panic attacks, which may last several minutes, usually involve such physical symp-toms as choking sensations or shortness of breath. Have you ever experienced panic? I can recall an episode when I was about 12 years old. My parents were out and I had watched a frightening show on television. Although I had no reason to do so, I became temporarily convinced that something horrible had happened to my parents. They were fine, of course, but the panic I expe-rienced was so intense that I still remember it clearly almost 50 years later.

We may all feel panic at some point in our lives, but imagine having these attacks several times each day. You’re sitting in class, trying to take notes, and the waves of fear start to wash over you for no apparent reason. Your ability to concentrate is destroyed; all your energy is directed toward trying to regain control. Such is the life of a person with panic disorder.

PhobiaAlmost everyone has heard the word phobia, which many people use to mean fear. (“I have a phobia about taking tests.”) To psychologists, however, a pho-bia is more than just a fear— it is a fear that is both irrational and disruptive. If you were being stalked on a dark street late at night, your fear of the stalker would not be irrational. But note that irrational fear alone is not enough to define phobia— the fear must also be disruptive. Most of us have irrational, nondisruptive fears— of harmless snakes or closed- in spaces, for example. My own particular irrational fear is the step from a ladder to a roof. Despite knowing that I can make the step safely, I hate it. I hate it to the extent that I have never been on the roof of the house in which I have lived for more than 20 years. If I were a roofer or a fireman, this fear would be disruptive. But I’m a teacher, and I seldom need to climb onto my roof. On those rare occasions when this becomes necessary, I simply have one of my sons do it or call some-one else to do the job. My fear is intense and irrational, but it’s not disruptive.

Table 31.1

Symptoms of Generalized Anxiety Disorder

Restlessness

Feeling on edge

Difficulty concentrating or mind going blank

Irritability

Muscle tension

Sleep disturbance

Source: Adapted from American Psychiatric Association (2000).

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Beyond the ClassroomGuest Speakergist who specializes in treating anxiety disorders and ask about treatment options available to people who have this class of disorders.

●

●

●


Why are phobias considered anxiety disorders? Because they focus gen-eral feelings of anxiety onto a feared object, activity, or situation (see Figure

31.2). Most phobias involve fear of a particular object, and their names are formed by combining the Greek word for the object with phobia, which is the Greek word for “fear.” Fear of spiders, for example, is called arachnophobia. Broader phobias also occur.

Social phobias produce fear in social situations. For example, some people have extreme difficulty speaking in public, even to the extent of being unable to respond to questions from a clerk in a store. Others cannot eat in the pres-ence of others or use public restrooms. As you might imagine, social phobias can seriously impair a person’s ability to lead a normal life.

Agoraphobia is fear of situations the person views as difficult to escape from if panic begins to build. Many people with this disorder become trapped in their own homes or in similar safe zones. I once had dinner with a woman from my town who was recovering from agoraphobia. She was a middle- aged widow who lived by herself and could not leave her home without experienc-ing intense fear. She described to me the difficulty of ordinary tasks like gro-cery shopping, which was to her similar to a military commando raid. Only with intense planning and determination could she leave her car, quickly col-lect the two or three items she needed most, and make it through checkout before dashing back to her car. Often she began to feel panicky during her

25%

20

15

10

5

0

Percentageof peoplesurveyed

Beingalone

Storms Water Closespaces

Flying Blood Height AnimalsPhobia

Fear

Figure 31.2

Some Common— and Not- So- Common— Fears

A national survey identi-fied the percentage of people indicating various specific fears. (From Curtis et al., 1998.)

Ophidiophobia

Even a swashbuckler like Indiana Jones is not immune to psychological disorders, in this case a phobia of snakes.

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2/a

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Have students explore the Internet to see how many different types of phobias they can find.

● What is the most obscure pho-bia they found?

● What was the most common phobia listed?

DigitAL connection

Fears in Other CulturesHave students research what things people in the United States fear most and whether people in other countries fear the same things.

● Do people in other cultures fear speaking in public as much as people in the United States seem to?

● Do fears differ among people of different socioeconomic groups? Why or why not?● Do people in countries that have experienced war have higher incidences of certain

anxiety disorders? What kinds?

At this point, you may want to use Analysis Activity: Social Phobias.

MuLticuLturAL connections TRM


554

31Differentiation TRMCompulsions manifest in several differ-ent ways.

● Hoarders collect things. They avoid throwing things away because they fear they may need them in the future. As a result, they keep everything, including leftover food, papers, and broken items.

● Checkers recheck actions they have already performed many times over. For example, someone who fears she did not turn off the oven will recheck it a certain number of times before she feels better.

● Counters count everything, from the steps they take to the words peo-ple say to them. They become pre-occupied with counting something seemingly unimportant to the point of stopping their daily progress.

● Cleaners clean excessively. Often, they need to clean a certain number of times in order to relieve the anxiety.

At this point, you may want to use the video resources As Good as It Gets and Obsessive-Compulsive Disorder: An Alternative Treatment.

Beyond the ClassroomDiscuss Have students recall old child-hood “rules” similar to “step on a crack and break your mother’s back.” Some rules they might remember could include “cootie shots” and supersti-tions like not breaking mirrors (or you’ll get seven years of bad luck) or not walking under ladders.

● Why do children develop these rules? What purpose do they serve?

● How do children learn these rules?● Do they remember being compulsive

about these rules? How did they feel when they broke the rules? What would they do to “make it right”?

DifferentiationFormer Nickelodeon game show host Marc Summers suffers from obsessive- compulsive disorder. He was the host of Double Dare and Family Double Dare, game shows that regu-larly subjected him and contestants on the show to being splattered with slime and goo. He often felt consumed by anxiety as he struggled to put on a cheerful face as the host of these shows. He currently hosts a nation-ally syndicated talk show, Unwrapped, on the Food Network, and is the national spokesman for the Obsessive- Compulsive Foundation.

Compulsions manifest in several differ-Compulsions manifest in several differ-Compulsions manifest in several differ

collect things. They avoid

recheck actions they have already performed many times over.

recheck it a certain number of times

the steps they take to the words peo-

seemingly unimportant to the point

of times in order to relieve the anxiety.

As Good as It Gets

Have students recall old child-hood “rules” similar to “step on a crack

Do they remember being compulsive about these rules? How did they feel


few minutes in the store, and sometimes she had to abandon her grocery shopping only to face another trial the next day. Over the course of the last 15 years, which had included some therapy, she had largely conquered her ago-raphobia. She was happy to say she had even been able to take a European vacation a few years ago.

Obsessive- Compulsive DisorderThe two major symptoms of obsessive- compulsive disorder are, as you might imagine, obsessions and compulsions. Obsessions are repetitive thoughts, and compulsions are repetitive actions. Almost everyone experiences both symptoms to some degree on a harmless level. In my classroom, I notice a lot of faraway stares as homecoming and prom weekends approach. I know many of these students can’t stop thinking about the upcoming event (at least that was the case for me when I was a student!). Other times we may hear a song and then be unable to get it out of our head.

We all have compulsions, too. One day I watched a student walk down the hall tapping the eraser of his pencil on every locker. Somehow he missed the last locker in the row and managed to make it about 10 yards down the hall before having to return to tap that last locker. You could almost feel his dis-comfort until the task was complete. You may have done something similar as a child. Remember that old rhyme about “step on a crack and break your mother’s back”? Were you able to step on sidewalk cracks easily after learning that rhyme?

Obsessive- compulsive tendencies can be helpful sometimes. Most good athletes are obsessed with winning and compulsive about training. And most good students are a bit obsessed with grades and a bit compulsive about studying. These tendencies help us develop important routines, such as fastening our safety belt when we get in a car or brushing our teeth regularly.

Obsessions and compulsions, however, begin to take control with some people, and this is when helpful tendencies become OCD. One common

Don’t Touch Me

The title of Howie Mandel’s 2009 memoir clearly illus-trates the comedian and TV host’s germ phobia.

© m

ar

io a

nz

uo

ni/

reu

Ter

s/c

or

Bis


obsession focuses on germs and develops with a compulsion in the form of repetitive hand washing. Individuals may wash their hands hundreds of times each day. Often, they engage in a hand- washing ritual that may take many minutes to complete, much like a surgeon scrubbing up before an operation. As long as such people have the opportunity to engage in their rituals, their anxiety remains under control. If they are somehow prevented from engaging in their ritual behavior, then anxiety and panic rapidly build.

Other common patterns of OCD involve dressing rituals, where a person may take hours to shower and dress each morning because he has hundreds of required steps that must be followed. Another common pattern is checking and rechecking a lock or an electrical switch. The person might return to the car 10 times in a row to make sure the lights are off and the door is locked. Table 31.2 lists some common obsessions and compulsions of children and adolescents with this disorder.

Post- Traumatic Stress DisorderWhat do military combat veterans, rape victims, abused children, and rescue workers who have to clean up gruesome accident sites have in common? They are all at increased risk for post- traumatic stress disorder. Intense stress is the trigger, and symptoms include nightmares, persistent fear, difficulty relating normally to others, and troubling memories of or flashbacks to the traumatic event (American Psychiatric Association, 2000).

The September 11, 2001, attacks on the World Trade Center and the Pen-tagon were events with the potential to produce many cases of PTSD, with one study showing that 20 percent of the people living near the World Trade Center experienced symptoms like nightmares (Susser et al., 2002). Children may be particularly vulnerable because witnessing or experiencing trauma

Table 31.2

Common Obsessions and Compulsions Among Children and Adolescents With Obsessive- Compulsive Disorder

Thought or BehaviorPercentage

Reporting Symptom

● Obsessions (repetitive thoughts)

Concern with dirt, germs, or toxins 40

Something terrible happening (fire, death, illness) 24

Symmetry, order, or exactness 17

● Compulsions (repetitive behaviors)

Excessive hand washing, bathing, toothbrushing, or grooming 85

Repeating rituals (in/out of a door, up/down from a chair) 51

Checking doors, locks, appliances, car brakes, homework 46

Source: Adapted from Rapoport (1989).


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31

Beyond the Classroom TRMDiscuss Thanks to 24- hour news channels and the growth of the Internet, media coverage of worldwide events is available almost immediately. People can watch troubling events as they unfold, including war, violence, and natural disasters. Ask: How does viewing trauma on televi-sion affect people who haven’t experienced the tragedy or conflict firsthand? Would someone who lived through a traumatic experience have a harder time with PTSD than someone who watched news footage of the experience?

At this point, you may want to watch Post-Traumatic Stress Disorder.

Beyond the ClassroomBellringers Use the following prompts as discussion starters:

● What behavior do you exhibit that might be considered “compulsive”? Why do you behave that way?

● What compulsive behaviors do you exhibit that are helpful to you? What behaviors are hurtful?

Reteach TRMOCD and OCPD Help students differ-entiate between obsessive- compulsive disorder (OCD) and obsessive- compulsive personality disorder (OCPD).

● OCD is an anxiety disorder charac-terized by obsessive thoughts and corresponding compulsions. People with OCD must repeat tasks over and over to find relief from their anxieties.

● OCPD is a personality disorder characterized by an obsessive need for neatness, order, and symmetry. People with OCPD are likely to be called “neat freaks” or described as “anal- retentive.”

At this point, you may want to use Analysis Activity: Obsessive- Compulsive Disorder.

Beyond the Classroom TRMCritical Thinking Remind students that behaviors are not considered abnormal unless they are maladaptive, unjustifiable, disturbing, and atypical. Have students answer the following questions:

● Where is the line between having a helpful, harmless obsession or com-pulsion and developing OCD?

● If you had a friend who exhibited a compulsion, what type of behaviors would cause you to become con-cerned about the person’s welfare?

At this point, you may want to use Enrichment Lesson: Obsessive Thoughts.

DifferentiationRemind students that the frontal lobes are responsible for judgment and deci-sion making. If people with OCD have overactive frontal lobes, then they are controlled by overzealous decision making. They cannot control the deci-sions they make, so they allow their behavior to be ruled by repetitive and overbearing thoughts.


few minutes in the store, and sometimes she had to abandon her grocery shopping only to face another trial the next day. Over the course of the last 15 years, which had included some therapy, she had largely conquered her ago-raphobia. She was happy to say she had even been able to take a European vacation a few years ago.

Obsessive- Compulsive DisorderThe two major symptoms of obsessive- compulsive disorder are, as you might imagine, obsessions and compulsions. Obsessions are repetitive thoughts, and compulsions are repetitive actions. Almost everyone experiences both symptoms to some degree on a harmless level. In my classroom, I notice a lot of faraway stares as homecoming and prom weekends approach. I know many of these students can’t stop thinking about the upcoming event (at least that was the case for me when I was a student!). Other times we may hear a song and then be unable to get it out of our head.

We all have compulsions, too. One day I watched a student walk down the hall tapping the eraser of his pencil on every locker. Somehow he missed the last locker in the row and managed to make it about 10 yards down the hall before having to return to tap that last locker. You could almost feel his dis-comfort until the task was complete. You may have done something similar as a child. Remember that old rhyme about “step on a crack and break your mother’s back”? Were you able to step on sidewalk cracks easily after learning that rhyme?

Obsessive- compulsive tendencies can be helpful sometimes. Most good athletes are obsessed with winning and compulsive about training. And most good students are a bit obsessed with grades and a bit compulsive about studying. These tendencies help us develop important routines, such as fastening our safety belt when we get in a car or brushing our teeth regularly.

Obsessions and compulsions, however, begin to take control with some people, and this is when helpful tendencies become OCD. One common

Don’t Touch Me

The title of Howie Mandel’s 2009 memoir clearly illus-trates the comedian and TV host’s germ phobia.

© m

ar

io a

nz

uo

ni/

reu

Ter

s/c

or

Bis

Beyond the Classroom TRM

Beyond the ClassroomBellringersas discussion starters:

●

●

Reteach OCD and OCPDentiate between obsessive-disorder (OCD) and obsessive-compulsive personality disorder (OCPD).

●

●

use Compulsive Disorder.

Beyond the Classroom Critical Thinkingthat behaviors are not considered abnormal unless they are maladaptive, unjustifiable, disturbing, and atypical. Have students answer the following questions:

●

●


obsession focuses on germs and develops with a compulsion in the form of repetitive hand washing. Individuals may wash their hands hundreds of times each day. Often, they engage in a hand- washing ritual that may take many minutes to complete, much like a surgeon scrubbing up before an operation. As long as such people have the opportunity to engage in their rituals, their anxiety remains under control. If they are somehow prevented from engaging in their ritual behavior, then anxiety and panic rapidly build.

Other common patterns of OCD involve dressing rituals, where a person may take hours to shower and dress each morning because he has hundreds of required steps that must be followed. Another common pattern is checking and rechecking a lock or an electrical switch. The person might return to the car 10 times in a row to make sure the lights are off and the door is locked. Table 31.2 lists some common obsessions and compulsions of children and adolescents with this disorder.

Post- Traumatic Stress DisorderWhat do military combat veterans, rape victims, abused children, and rescue workers who have to clean up gruesome accident sites have in common? They are all at increased risk for post- traumatic stress disorder. Intense stress is the trigger, and symptoms include nightmares, persistent fear, difficulty relating normally to others, and troubling memories of or flashbacks to the traumatic event (American Psychiatric Association, 2000).

The September 11, 2001, attacks on the World Trade Center and the Pen-tagon were events with the potential to produce many cases of PTSD, with one study showing that 20 percent of the people living near the World Trade Center experienced symptoms like nightmares (Susser et al., 2002). Children may be particularly vulnerable because witnessing or experiencing trauma

Table 31.2

Common Obsessions and Compulsions Among Children and Adolescents With Obsessive- Compulsive Disorder

Thought or BehaviorPercentage

Reporting Symptom

● Obsessions (repetitive thoughts)

Concern with dirt, germs, or toxins 40

Something terrible happening (fire, death, illness) 24

Symmetry, order, or exactness 17

● Compulsions (repetitive behaviors)

Excessive hand washing, bathing, toothbrushing, or grooming 85

Repeating rituals (in/out of a door, up/down from a chair) 51

Checking doors, locks, appliances, car brakes, homework 46

Source: Adapted from Rapoport (1989).


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31Beyond the ClassroomDiscuss For many people who expe-rience trauma, the events occurring before, during, and directly after the event become etched into their minds, forming a flashbulb memory of the event. Ask:

● Do you remember vividly where you were when you heard about the events of September 11 or the space shuttle Columbia accident?

● Do your parents remember vividly the space shuttle Challenger acci-dent, the attempted assassination of Ronald Reagan, or when John Len-non was killed?

event become etched into their minds,

you were when you heard about the events of September 11 or the space

dent, the attempted assassination of


may instill a sense of hopelessness about the future and may impair their ability to trust. The negative consequences of bad experiences can produce increased anxiety and other symptoms for many years. PTSD can have a par-ticularly devastating impact on combat veterans. One in four U.S. veterans from the conflicts in Iraq and Afghanistan were diagnosed with a psycho-logical disorder in one study, and the most frequent of these was PTSD (Seal et al., 2007). (For encouraging news on reducing the incidence of PTSD in soldiers and others, see Thinking About Positive Psychology: Comprehensive Soldier Fitness.)

Stress is a constant in life— everybody experiences difficult events— but the response to stress is not the same for everyone. Why is it that some people struggle in the face of adversity while others seem to survive or even thrive? Far more people experience trauma than develop post- traumatic stress disorder (Ozer & Weiss, 2004). Most combat veterans and even most victims of political torture do not develop PTSD. What deter-mines who does and who doesn’t?

Those who make it through the aftermath of trauma largely unscathed possess a quality known as survivor resiliency (Bonanno, 2004, 2005). Some go beyond

resiliency and experience post- traumatic growth. Their suffering has led to inner strength, increased appreciation, and better relationships. A primary goal of positive psychology is to increase the percentage of people who can weather the storms of trauma more effectively. The key seems to be to prepare people in advance with cognitive and behavioral strategies that allow them to cope with stress more effectively.

Is this possible? It is increasingly looking like the answer is Yes. Work done by Martin Seligman and his colleagues to develop positive education in school systems has resulted in programs that teach teach-ers how to develop resiliency skills in students (Selig-man et al., 2009). These programs have shown lasting reductions in anxiety and depression among the stu-dents who are taught the new skills.

Perhaps the most ambitious initiative of all began in 2009 with the start of the U.S. Army’s Comprehen-sive Soldier Fitness (CSF) program (Casey, 2011). Under this program, Seligman’s team at the Univer-sity of Pennsylvania is preparing thousands of Army master resiliency trainers. These master trainers will teach appropriate resiliency skills to Army leaders in every battalion and brigade. All new recruits will learn resiliency skills as a part of their basic training. The family members of soldiers and civilian workers in the military will be trained as well. All these individuals are, or are close to, people at high risk for PTSD, especially when soldiers are deployed in combat. The goal is to increase resiliency to prevent psychological disorders and help everyone live healthier, happier lives.

Comprehensive Soldier Fitness

Thinking About P O S I T I V E P S Y C H O L O G Y

Combat and Stress

One goal of positive psychology is to prevent psy-chological problems related to the stress of combat. Helping soldiers and their families become more resilient may result in fewer problems to treat when the soldiers return from war.

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Causes of Anxiety DisordersAnxiety disorders could be caused by nature (the effect of our inherited biol-ogy) or nurture (the influence of our environment). As is almost always the case, both factors are important.

Biological Factors Anxiety disorders, like so many other areas that psy-chologists study, illustrate the interaction between our biology and our envi-ronment. Some biological factors that contribute to anxiety disorders are these:

● Heredity— Some of us inherit a predisposition, or likelihood, for devel-oping anxiety disorders. Evidence for this comes from studies of identi-cal twins, who are genetically the same. Even when raised in different families, identical twins sometimes have similar phobias (Carey, 1990; Eckert et al., 1981). The influence of heredity is also apparent in mon-key studies demonstrating that fearful parents are likely to have fearful children (Suomi, 1986). The specific fear is not inherited, but the pre-disposition to be fearful is. The search is on for the genes that lead to this predisposition, and 17 genes with connections to anxiety disorder symptoms have been identified (Hovatta et al., 2005).

● Brain function— Brain- scanning techniques show that people with anxi-ety disorders have brains that literally function differently than those of people who do not have anxiety disorders. As Figure 31.3 illustrates, brain scans show a higher degree of activity in a part of the frontal lobes of people with OCD (Ursu et al., 2003). Because the frontal lobes are involved with decision making, the bright red and yellow shown in that area of the brain of the person with OCD may indicate a source of the problem. An emotion center, the amygdala, also shows differences for people with phobias (Etkin & Wager, 2007; Kolassa & Elbert, 2007; Maren, 2007). It’s possible that their intense fear is caused by the activ-ity in the amygdala. Because brain function is involved, anxiety disor-ders often respond to treatment with medication.

● Evolution— We are likely to fear situations that posed danger to the earliest humans. Dangerous animals, heights, and storms were

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Figure 31.3

The Brain and Obsessive- Compulsive Disorder

Brain scans have been used to show that people with obsessive- compulsive disorder (OCD) have more activity in decision- making areas at the front of the brain than do people without OCD. The red and yellow on this brain scan indicate increased activity in a part of the brain known as the anterior cingu-late cortex.

PTSD and Traumatic EventsHave students research the changes that occurred during the last century regarding the diagno-sis and treatment of PTSD. How were people in the past expected to behave after experiencing trauma? Were treatments available? Con-sider the following events that may have caused PTSD:

● Wars and conflicts, such as the two world wars, Korean, Viet-nam, and the two Gulf Wars

● Terrorism, such as that which occurred on September 11, 2001

● Natural disasters, such as Hur-ricanes Andrew and Katrina

At this point, you may want to use Enrichment Lesson: Con-centration Camp Survival.

Active LeArning TRM

Active LeArning TRM

Personal InterviewsHave students interview people who experienced trauma in the twentieth century to see how they coped with the stress involved with a particularly tragic event. Some people stu-dents may consider interviewing include

● veterans of World War II or the Korean, Vietnam, or Gulf Wars.● those who remember the assassinations of the 1960s.● survivors of or witnesses to the Holocaust or the September 11 terrorist attacks.● evacuees from Hurricanes Andrew, Hugo, or Katrina.

At this point, you may want to use Enrichment Lesson: Concentration Camp Survival.


557

31Beyond the Classroom TRMAnalyze Have students name fears that have evolved to help further our species. Have them ponder how some common fears might have evolved:

● Public speaking● Flying● Germs● Failure

At this point, you may want to use The Mind (2nd ed.), Module 32: “Mood Disorders: Hereditary Factors.”

Differentiation TRMLife Without Fear What would life be without fear? Have students offer scenarios in which fear is detrimental and useful to daily life. If fear weren’t an issue, how would these situations be different?

At this point, you may want to use Application Activity: Fear Survey.


may instill a sense of hopelessness about the future and may impair their ability to trust. The negative consequences of bad experiences can produce increased anxiety and other symptoms for many years. PTSD can have a par-ticularly devastating impact on combat veterans. One in four U.S. veterans from the conflicts in Iraq and Afghanistan were diagnosed with a psycho-logical disorder in one study, and the most frequent of these was PTSD (Seal et al., 2007). (For encouraging news on reducing the incidence of PTSD in soldiers and others, see Thinking About Positive Psychology: Comprehensive Soldier Fitness.)

Stress is a constant in life— everybody experiences difficult events— but the response to stress is not the same for everyone. Why is it that some people struggle in the face of adversity while others seem to survive or even thrive? Far more people experience trauma than develop post- traumatic stress disorder (Ozer & Weiss, 2004). Most combat veterans and even most victims of political torture do not develop PTSD. What deter-mines who does and who doesn’t?

Those who make it through the aftermath of trauma largely unscathed possess a quality known as survivor resiliency (Bonanno, 2004, 2005). Some go beyond

resiliency and experience post- traumatic growth. Their suffering has led to inner strength, increased appreciation, and better relationships. A primary goal of positive psychology is to increase the percentage of people who can weather the storms of trauma more effectively. The key seems to be to prepare people in advance with cognitive and behavioral strategies that allow them to cope with stress more effectively.

Is this possible? It is increasingly looking like the answer is Yes. Work done by Martin Seligman and his colleagues to develop positive education in school systems has resulted in programs that teach teach-ers how to develop resiliency skills in students (Selig-man et al., 2009). These programs have shown lasting reductions in anxiety and depression among the stu-dents who are taught the new skills.

Perhaps the most ambitious initiative of all began in 2009 with the start of the U.S. Army’s Comprehen-sive Soldier Fitness (CSF) program (Casey, 2011). Under this program, Seligman’s team at the Univer-sity of Pennsylvania is preparing thousands of Army master resiliency trainers. These master trainers will teach appropriate resiliency skills to Army leaders in every battalion and brigade. All new recruits will learn resiliency skills as a part of their basic training. The family members of soldiers and civilian workers in the military will be trained as well. All these individuals are, or are close to, people at high risk for PTSD, especially when soldiers are deployed in combat. The goal is to increase resiliency to prevent psychological disorders and help everyone live healthier, happier lives.

Comprehensive Soldier Fitness

Thinking About P O S I T I V E P S Y C H O L O G Y

Combat and Stress

One goal of positive psychology is to prevent psy-chological problems related to the stress of combat. Helping soldiers and their families become more resilient may result in fewer problems to treat when the soldiers return from war.

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Beyond the ClassroomAnalyzethat have evolved to help further our species. Have them ponder how some common fears might have evolved:

●

●

●

●

use 32: “Mood Disorders: Hereditary Factors.”

DifferentiationLife Without Fearbe without fear? Have students offer scenarios in which fear is detrimental and useful to daily life. If fear weren’t an issue, how would these situations be different?

Application


Causes of Anxiety DisordersAnxiety disorders could be caused by nature (the effect of our inherited biol-ogy) or nurture (the influence of our environment). As is almost always the case, both factors are important.

Biological Factors Anxiety disorders, like so many other areas that psy-chologists study, illustrate the interaction between our biology and our envi-ronment. Some biological factors that contribute to anxiety disorders are these:

● Heredity— Some of us inherit a predisposition, or likelihood, for devel-oping anxiety disorders. Evidence for this comes from studies of identi-cal twins, who are genetically the same. Even when raised in different families, identical twins sometimes have similar phobias (Carey, 1990; Eckert et al., 1981). The influence of heredity is also apparent in mon-key studies demonstrating that fearful parents are likely to have fearful children (Suomi, 1986). The specific fear is not inherited, but the pre-disposition to be fearful is. The search is on for the genes that lead to this predisposition, and 17 genes with connections to anxiety disorder symptoms have been identified (Hovatta et al., 2005).

● Brain function— Brain- scanning techniques show that people with anxi-ety disorders have brains that literally function differently than those of people who do not have anxiety disorders. As Figure 31.3 illustrates, brain scans show a higher degree of activity in a part of the frontal lobes of people with OCD (Ursu et al., 2003). Because the frontal lobes are involved with decision making, the bright red and yellow shown in that area of the brain of the person with OCD may indicate a source of the problem. An emotion center, the amygdala, also shows differences for people with phobias (Etkin & Wager, 2007; Kolassa & Elbert, 2007; Maren, 2007). It’s possible that their intense fear is caused by the activ-ity in the amygdala. Because brain function is involved, anxiety disor-ders often respond to treatment with medication.

● Evolution— We are likely to fear situations that posed danger to the earliest humans. Dangerous animals, heights, and storms were

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, V. a

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Figure 31.3

The Brain and Obsessive- Compulsive Disorder

Brain scans have been used to show that people with obsessive- compulsive disorder (OCD) have more activity in decision- making areas at the front of the brain than do people without OCD. The red and yellow on this brain scan indicate increased activity in a part of the brain known as the anterior cingu-late cortex.


558

31DifferentiationReview with students the components of classical conditioning that caused Little Albert to develop a fear of white, furry objects:

● Unconditioned stimulus (US): the loud “bang” that occurred when the lead pipes were struck

● Unconditioned response (UR): fear of the loud “bang”

● Conditioned stimulus (CS): white, furry objects

● Conditioned response (CR): fear, but this time in response to the white, furry object

Have students recall that the fear response John Watson cultivated so easily was reversed in other patients by his student Mary Cover Jones. She used classical conditioning to remove a fear response from individuals who had developed a fear of a cer-tain object. She used a pleasant US, like candy or food, so patients could associate the pleasant feeling with the object they had come to fear.

Review with students the components

Little Albert to develop a fear of white,

Conditioned response (CR): fear, but


threats, and people who didn’t have a healthy dose of fear were less likely to survive. Those who did survive passed on to us— their descendants— their tendency to fear these dangers. Many of us share these fears to this day, even though our modern world has made these threats less dangerous than they once were. For exam-ple, preschool children can find a snake in a scene more quickly than they can find a flower or a frog (LoBue & DeLoache, 2008). Unfortunately, we don’t have a similar inherited tendency to fear threats that have developed more recently. Cars, for example, kill far more people in the modern world than snakebites do, yet more people fear snakes than fear cars.

Learning Factors Learning gone awry can also produce anxiety disor-ders. Sometimes we learn to respond well in stressful situations, but if we learn maladaptive responses they can blossom into anxiety disorders. These factors can contribute:

● Conditioning— Ivan Pavlov became famous for his studies in which dogs learned to associate the sound of a tuning fork with the taste of meat, salivating equally to both. Humans can also learn to associ-ate fear with certain places or things. John B. Watson and Rosalie Rayner (1920) demonstrated this in their famous research with “Little Albert,” an infant who learned to fear white rats. Watson and Rayner established the fear by pairing the sight of a rat with loud, frightening noises. Few of us would deliberately teach a child fear, but the child might learn to associate fear and dogs if exposed to a menacing growl or bite when young. Unpredictable and uncontrollable bad events can contribute to the conditioning of anxiety (Field, 2006; Mineka & Zin-barg, 2006).

● Observational learning— Children can also learn fears at their parents’ knees. If a child sees a parent or older sibling responding with fear to thunderstorms, bees, or high places, the child may begin to experi-ence the same fear. Even young monkeys learned to fear snakes when given the opportunity to watch other monkeys avoid situations in which a snake was present (Mineka, 1985).

Heredity and Fear

We don’t appear to inherit specific fears, but we do inherit a predisposition to develop fears. This is why identical twins are more likely than other siblings to share the same fears, even if they are not raised together.

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● Reinforcement— We also learn to associate emotions with actions, depending on the results that follow those actions. A person with a fear of heights can reduce the fear by avoiding heights. That release from anxiety makes it more likely that the person will avoid heights in the future. A person with an obsessive- compulsive hand- washing ritual can reduce anxiety by washing and will therefore repeat that action. We tend to repeat responses that have good results and avoid those that have bad results.

No one has an anxiety- free life. But when the anxiety begins to take control (as in the case of a generalized anxiety disorder), refocus as fear (as in the case of a phobia), drive us to rigidly repeated thoughts and behaviors (as in the case of obsessive- compulsive disorder), or make it impossible to escape an earlier horror (as in the case of post- traumatic stress disorder), anxiety has crossed the line and has become a psychological disorder.

Pause Now or Move oN

Turn to page 567 to review and apply what you’ve learned.

Mood DisordersWHAT’S THE POINT?

31-2 What are the mood disorders, and what causes them?

Mood disorders are disturbances of emotions. Like other psychological dis-orders you’ve read about in this module, mood disorders are magnifications of our normal reactions. The magnified states in mood disorders are mania and depression. Mania is a period of abnormally high emotion and activity. Has anyone ever said to you, “Don’t be so manic”? People often use that statement when they simply mean “Calm down— don’t get so excited.” Life would be dull if we could never feel elated or excited or wildly enthusiastic. But what if you felt intense mania for days or even weeks and just couldn’t calm down? As you’ll see later in this section, some people do, and it’s not pleasant.

It is a rare individual who never feels depressed. Can any of us say that we never feel down, sad, or drained of energy? Depression is a normal response to the loss of many of the important things in life, including the death of loved ones, the end of important relationships, the loss of a job, or even graduation from the comfortable familiarity of high school (Wakefield et al., 2007). We can even become depressed over distant events, such as famines or outbreaks of violence in far corners of the world. From an evolutionary perspective,

Nature or Nurture?

The baby may be biologi-cally predisposed to fear heights, but she may also learn this fear by watching her mother.

Depression

Anguished depression can be a normal response to tragic events. Specific cri-teria must be met before a diagnosis of major depres-sive disorder is made.

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● Have you ever felt depressed? What caused your depression? How did you handle it?

● Are certain points in your day, week, month, or year more likely to leave you depressed? Why?

At this point, you may want to use the video resources No More Shame: Understanding Schizophre-nia, Depression, and Addiction and Depression: Beating the Blues.

Differentiation TRMNational Depression Screening Day is held annually in October. This is a nationwide event at which mental health professionals offer free depres-sion screenings to the public. The free screening includes completion of a self- rating depression scale; a 20- minute discussion about the causes, symptoms, and treatment of depres-sion; and a 5- minute meeting one- on- one with a mental health professional. Based on the scale scores and the clinician’s probing, participants learn if they need more evaluation. No diag-nosis or treatment is provided.

At this point, you may want to use Application Activity: The Zung Self- Rating Depression Scale.


threats, and people who didn’t have a healthy dose of fear were less likely to survive. Those who did survive passed on to us— their descendants— their tendency to fear these dangers. Many of us share these fears to this day, even though our modern world has made these threats less dangerous than they once were. For exam-ple, preschool children can find a snake in a scene more quickly than they can find a flower or a frog (LoBue & DeLoache, 2008). Unfortunately, we don’t have a similar inherited tendency to fear threats that have developed more recently. Cars, for example, kill far more people in the modern world than snakebites do, yet more people fear snakes than fear cars.

Learning Factors Learning gone awry can also produce anxiety disor-ders. Sometimes we learn to respond well in stressful situations, but if we learn maladaptive responses they can blossom into anxiety disorders. These factors can contribute:

● Conditioning— Ivan Pavlov became famous for his studies in which dogs learned to associate the sound of a tuning fork with the taste of meat, salivating equally to both. Humans can also learn to associ-ate fear with certain places or things. John B. Watson and Rosalie Rayner (1920) demonstrated this in their famous research with “Little Albert,” an infant who learned to fear white rats. Watson and Rayner established the fear by pairing the sight of a rat with loud, frightening noises. Few of us would deliberately teach a child fear, but the child might learn to associate fear and dogs if exposed to a menacing growl or bite when young. Unpredictable and uncontrollable bad events can contribute to the conditioning of anxiety (Field, 2006; Mineka & Zin-barg, 2006).

● Observational learning— Children can also learn fears at their parents’ knees. If a child sees a parent or older sibling responding with fear to thunderstorms, bees, or high places, the child may begin to experi-ence the same fear. Even young monkeys learned to fear snakes when given the opportunity to watch other monkeys avoid situations in which a snake was present (Mineka, 1985).

Heredity and Fear

We don’t appear to inherit specific fears, but we do inherit a predisposition to develop fears. This is why identical twins are more likely than other siblings to share the same fears, even if they are not raised together.

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Beyond the Classroom Bellringersas discussion starters:

●

●

use the video resourcesShame: Understanding Schizophrenia, Depression, and Addiction Depression: Beating the Blues.

DifferentiationNational Depression Screening Day is held annually in October. This is a nationwide event at which mental health professionals offer free depression screenings to the public. The free screening includes completion of a self-20-symptoms, and treatment of depression; and a 5-one with a mental health professional. Based on the scale scores and the clinician’s probing, participants learn if they need more evaluation. No diag


● Reinforcement— We also learn to associate emotions with actions, depending on the results that follow those actions. A person with a fear of heights can reduce the fear by avoiding heights. That release from anxiety makes it more likely that the person will avoid heights in the future. A person with an obsessive- compulsive hand- washing ritual can reduce anxiety by washing and will therefore repeat that action. We tend to repeat responses that have good results and avoid those that have bad results.

No one has an anxiety- free life. But when the anxiety begins to take control (as in the case of a generalized anxiety disorder), refocus as fear (as in the case of a phobia), drive us to rigidly repeated thoughts and behaviors (as in the case of obsessive- compulsive disorder), or make it impossible to escape an earlier horror (as in the case of post- traumatic stress disorder), anxiety has crossed the line and has become a psychological disorder.



Mood DisordersWHAT’S THE POINT?


Mood disorders are disturbances of emotions. Like other psychological dis-orders you’ve read about in this module, mood disorders are magnifications of our normal reactions. The magnified states in mood disorders are mania and depression. Mania is a period of abnormally high emotion and activity. Has anyone ever said to you, “Don’t be so manic”? People often use that statement when they simply mean “Calm down— don’t get so excited.” Life would be dull if we could never feel elated or excited or wildly enthusiastic. But what if you felt intense mania for days or even weeks and just couldn’t calm down? As you’ll see later in this section, some people do, and it’s not pleasant.

It is a rare individual who never feels depressed. Can any of us say that we never feel down, sad, or drained of energy? Depression is a normal response to the loss of many of the important things in life, including the death of loved ones, the end of important relationships, the loss of a job, or even graduation from the comfortable familiarity of high school (Wakefield et al., 2007). We can even become depressed over distant events, such as famines or outbreaks of violence in far corners of the world. From an evolutionary perspective,

Nature or Nurture?

The baby may be biologi-cally predisposed to fear heights, but she may also learn this fear by watching her mother.

Depression

Anguished depression can be a normal response to tragic events. Specific cri-teria must be met before a diagnosis of major depres-sive disorder is made.

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ResearchThere are several different types of mood disorders that are not classified in the DSM. Have students research the following disorders, concentrating on why they are not included in the DSM:

● Seasonal affective disorder● Postpartum depression

At this point, you may want to use The Mind (2nd ed.), Module 31: “Mood Disorders: Mania and Depression.”

Active LeArning TRM

Active LeArning TRM

The Mood ContinuumDivide students into small groups and have them create a continuum of the different types of mood, with depression on one extreme and mania on the other. Have them come up with at least five different levels of mood between the two extremes.

● Could groups come to a consensus about what the different types of mood should be called? Why or why not?

● What were the different names they came up with for each type of mood?

At this point, you may want to use The Mind (2nd ed.), Module 31: “Mood Disor-ders: Mania and Depression.”


560

31Differentiation TRMDysthymic disorder is a depressive state that lasts more than two years in adults or more than one year in adoles-cents and children. Patients must also present two or more of the following symptoms:

● Poor appetite or overeating● Insomnia or hypersomnia● Low energy or fatigue● Low self- esteem● Poor concentration or difficulty

making decisions● Feelings of hopelessness

At this point, you may want to use Enrichment Lesson: Postpartum Depression.

state that lasts more than two years in adults or more than one year in adoles-cents and children. Patients must also


depression probably exists to give us time to slow down and reflect on why a bad thing has occurred. This allows us to perhaps avoid similar losses in the future (Watkins, 2008). How do we know where to draw the line between normal reaction and mood disorder? Keep this question in mind as we con-sider the two main mood disorders, major depressive disorder and bipolar disorder (see Figure 31.4).

Major Depressive DisorderMajor depressive disorder is the most common disability in the world, affecting almost 6 percent of men and nearly 10 percent of women (World Health Organization, 2002). Among college students, 44 percent in one sur-vey said that they had been depressed enough that it was difficult to func-tion at least once in the past year (American College Health Association, 2006). Therapists say that depression has crossed the line from a normal reaction to major depressive disorder when five of the following nine symp-toms have been present for two or more weeks (note that one of the first two symptoms must be included in those five) (American Psychiatric Associa-tion, 2000):

● Depressed mood most of the day, nearly every day (in children and ado-lescents, an irritated mood satisfies this requirement)

● Little interest or pleasure in almost all activities

● Significant changes in weight or appetite

● Sleeping more or less than usual

● Agitated or decreased level of activity

● Fatigue or loss of energy

● Feelings of worthlessness or inappropriate guilt

● Diminished ability to think or concentrate

● Recurrent thoughts of death or suicide

These symptoms must also produce distress or impaired functioning to qualify as indicators of major depressive disorder. One of the main differ-ences between major depressive disorder and normal grief is the apparent

MoodDisorders

Bipolar Disorder

Alternating periods ofmania and depression

Major Depressive Disorder

Depressed mood lasting at leasttwo weeks, diminished interest

in activities, and other symptoms

Figure 31.4

Mood Disorders

Such disorders are distur-bances of emotion.

major depressive disorder A mood disorder in which a person, for no apparent reason, experiences at least two weeks of depressed moods, diminished interest in activities, and other symptoms, such as feelings of worthlessness.


reason for the emotions. Grief over the loss of a loved one is an understand-able reaction. In contrast, there may be no apparent trigger for major depres-sive disorder.

Major depressive disorder feels like an inescapable weight affecting every aspect of life, and it can even lead to suicide (see Psychology in the Real World: Suicide on pages 562–563).

Bipolar DisorderPeople with bipolar disorder (previously known as manic depressive disor-der) alternate between the hopelessness of depression and the overexcited and unreasonably optimistic state of mania. This disorder is less common than major depressive disorder, but it has a more devastating effect on peo-ple’s ability to function. Twice as many workdays are lost each year to bipolar disorder than to major depression (Kessler et al., 2006).

It’s good to be optimistic, but the manic phases of someone with bipo-lar disorder are well beyond normal. During mania, the person may go long periods without sleeping and may experience racing thoughts, be easily dis-tracted, and set impossible goals.

These manic phases, like the bouts of depression that occur in major depressive disorder, tend to have hills and valleys. Moods generally follow cyclical patterns— most people find that they swing through some periods when they feel a little down and others where they feel great. Mania is some-times associated with bursts of creative energy (Jamison, 1993, 1995). Many well- known creative people, from Mark Twain to Vincent van Gogh, are believed to have suffered from bipolar disorder.

Causes of Mood DisordersAs with anxiety disorders, no single explanation sheds light on all mood dis-orders. Again, biology and environment interact. Stress also seems to play a role, providing a trigger that sparks mood disorders when other factors are present.

bipolar disorder A mood disorder (formerly called manic depressive disorder) in which the person alternates between the hopelessness of depression and the overexcited and unrea-sonably optimistic state of mania.

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It is difficult to diagnose mental illness in historical figures, but van Gogh quite possibly suffered from bipolar disorder. His life alternated between periods of blazing creativity— sometimes he finished more than a painting a day— and periods of deep depression. He committed suicide in 1890.

SurveyHave students conduct a study using Application Activity: The Zung Self- Rating Depression Scale. They should survey a sample of students to see the rates of depression among students in your building.

● Establish an institutional review board (IRB) composed of fellow teachers and admin-istrators who can review the experimental design to ensure all ethical standards are being followed.

● Be sure to obtain informed con-sent with each survey adminis-tered to conform with ethical standards.

● Have students write up their findings to publish in a high school journal or as a news item for the school’s newspaper. Be sure their report discusses depression based on well- researched facts.

Active LeArning TRM


561

31

Differentiation TRMWhat reasons do people give for being lonely? One survey sorted them into five major categories.

1. Being unattached Having no spouse or partner; particularly breaking up with a spouse or sig-nificant other

2. Alienation Being misunderstood and feeling different; not being needed and having no close friends

3. Being alone Coming home to an empty house

4. Forced isolation Being hospital-ized or housebound; having no transportation

5. Dislocation Being away from home; starting a new job or school; traveling often

At this point, you may want to use Analysis Activity: Loneliness.

Differentiation TRMHow do people cope with loneliness? Rubenstein and Shaver have found four major strategies:

● Sad passivity Sleeping, drinking, overeating, and watching TV

● Social contact Calling or visiting a friend

● Active solitude Studying, reading, exercising, or going to a movie

● Distractions Spending money and going shopping

At this point, you may want to use Analysis Activity: The Automatic Thoughts Questionnaire and Enrich-ment Lesson: The Sadder-but-Wiser Effect.

Source: Rubenstein, C. M., & Shaver, P. (1982). In search of intimacy. New York, NY: Delacorte Press.


depression probably exists to give us time to slow down and reflect on why a bad thing has occurred. This allows us to perhaps avoid similar losses in the future (Watkins, 2008). How do we know where to draw the line between normal reaction and mood disorder? Keep this question in mind as we con-sider the two main mood disorders, major depressive disorder and bipolar disorder (see Figure 31.4).

Major Depressive DisorderMajor depressive disorder is the most common disability in the world, affecting almost 6 percent of men and nearly 10 percent of women (World Health Organization, 2002). Among college students, 44 percent in one sur-vey said that they had been depressed enough that it was difficult to func-tion at least once in the past year (American College Health Association, 2006). Therapists say that depression has crossed the line from a normal reaction to major depressive disorder when five of the following nine symp-toms have been present for two or more weeks (note that one of the first two symptoms must be included in those five) (American Psychiatric Associa-tion, 2000):

● Depressed mood most of the day, nearly every day (in children and ado-lescents, an irritated mood satisfies this requirement)

● Little interest or pleasure in almost all activities

● Significant changes in weight or appetite

● Sleeping more or less than usual

● Agitated or decreased level of activity

● Fatigue or loss of energy

● Feelings of worthlessness or inappropriate guilt

● Diminished ability to think or concentrate

● Recurrent thoughts of death or suicide

These symptoms must also produce distress or impaired functioning to qualify as indicators of major depressive disorder. One of the main differ-ences between major depressive disorder and normal grief is the apparent

MoodDisorders

Bipolar Disorder

Alternating periods ofmania and depression

Major Depressive Disorder

Depressed mood lasting at leasttwo weeks, diminished interest

in activities, and other symptoms

Figure 31.4

Mood Disorders

Such disorders are distur-bances of emotion.

major depressive disorder A mood disorder in which a person, for no apparent reason, experiences at least two weeks of depressed moods, diminished interest in activities, and other symptoms, such as feelings of worthlessness.

DifferentiationWhat reasons do people give for being lonely? One survey sorted them into five major categories.

Analysis

Differentiation How do people cope with loneliness? Rubenstein and Shaver have found four major strategies:

●


reason for the emotions. Grief over the loss of a loved one is an understand-able reaction. In contrast, there may be no apparent trigger for major depres-sive disorder.

Major depressive disorder feels like an inescapable weight affecting every aspect of life, and it can even lead to suicide (see Psychology in the Real World: Suicide on pages 562–563).

Bipolar DisorderPeople with bipolar disorder (previously known as manic depressive disor-der) alternate between the hopelessness of depression and the overexcited and unreasonably optimistic state of mania. This disorder is less common than major depressive disorder, but it has a more devastating effect on peo-ple’s ability to function. Twice as many workdays are lost each year to bipolar disorder than to major depression (Kessler et al., 2006).

It’s good to be optimistic, but the manic phases of someone with bipo-lar disorder are well beyond normal. During mania, the person may go long periods without sleeping and may experience racing thoughts, be easily dis-tracted, and set impossible goals.

These manic phases, like the bouts of depression that occur in major depressive disorder, tend to have hills and valleys. Moods generally follow cyclical patterns— most people find that they swing through some periods when they feel a little down and others where they feel great. Mania is some-times associated with bursts of creative energy (Jamison, 1993, 1995). Many well- known creative people, from Mark Twain to Vincent van Gogh, are believed to have suffered from bipolar disorder.

Causes of Mood DisordersAs with anxiety disorders, no single explanation sheds light on all mood dis-orders. Again, biology and environment interact. Stress also seems to play a role, providing a trigger that sparks mood disorders when other factors are present.

bipolar disorder A mood disorder (formerly called manic depressive disorder) in which the person alternates between the hopelessness of depression and the overexcited and unrea-sonably optimistic state of mania.

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It is difficult to diagnose mental illness in historical figures, but van Gogh quite possibly suffered from bipolar disorder. His life alternated between periods of blazing creativity— sometimes he finished more than a painting a day— and periods of deep depression. He committed suicide in 1890.

There are two main types of bipo-lar disorder:

● Bipolar I Patients experi-ence periods of elevated mood (mania) accompanied by psy-chosis, followed by periods of major depression.

● Bipolar II Patients experience at least one episode of hypoma-nia (a period of elevated mood but without psychosis) and at least one major depressive episode.

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31TeaChing TiP TRMSuicide may be a sensitive subject, especially if students have known someone who has attempted or com-mitted suicide. Students may also have attempted suicide and not shared that with others. Students generally struggle with questions of life’s pur-pose, and these feelings are normal. Remind students that any indication of someone contemplating suicide should be taken seriously.

At this point, you may want to use Critical Thinking Activity: Depres-sion and Memory.

Beyond the Classroom TRMGuest Speaker Invite your school’s guidance counselor to discuss what your school’s plan would be in the event of a student committing suicide.

● How was the plan developed?● What outside resources would be

called in?● Is this plan similar to ones that

would be in place if a student died from causes other than suicide? How would it be different?

At this point, you may want to use Critical Thinking Activity: The Revised Facts on Suicide Quiz.

have attempted suicide and not shared

Remind students that any indication of someone contemplating suicide should

event of a student committing suicide.

died from causes other than suicide?


Biological Factors Our physical and psychological future is not written in our genes, but genetics does set limits on some of our choices. For mood disorders, both heredity and brain function appear to be important biologi-cal factors.

● Heredity— Many disorders run in families, and mood disorders are no exception. We can see the influence of heredity in twin studies. Geneti-cally, fraternal twins (who develop from two fertilized egg cells) differ from each other as much as any other two siblings. If one fraternal twin has major depressive disorder, the other twin has a 20 percent

Psychology in T H E R E A L W O R L D

When I was a junior in high school, back in the late 1960s, a fellow student didn’t appear for class one day shortly after breaking up with a longtime girl-friend. As the day wore on, rumors that he had com-mitted suicide began to travel through the student body. The rumors proved to be true, but nobody ever dealt with the issue openly. Teachers, counselors, administrators, and parents seemed united in their desire not to talk about something they found dis-turbing and unexplainable. Students were left to sort out their questions and feelings on their own, and the school never even issued an official acknowledgment of what had happened.

There have also been student suicides, and suicide attempts, in the school where I now teach. Seeing this important issue brought into the open has been gratify-ing. In recent years, the administration put into place a crisis response plan to help both students and faculty members cope with the emotional effect of the loss or injury of a student. Instead of pretending that noth-ing has happened, the school issues announcements, runs articles in the school newspaper, and ensures that counselors are available to help friends and class-mates with their grief and questions. Bringing the topic of suicide into the light of day may prevent others from making this tragic choice.

One interesting fact about suicide is that people who are deeply depressed rarely kill themselves until after the depression starts to lift. This is confusing to friends, because the suicide occurs just as the per-son seems to be getting better. Ironically, this lifting of depression gives the person the energy to execute a

plan developed when depression was so overwhelm-ing that it effectively stopped action.

For adolescents, to have occasional, passing thoughts of suicide is neither unusual nor a cause for concern. But becoming obsessed with thoughts of suicide, or starting to develop plans for commit-ting suicide, is. It’s quite likely that a suicide or suicide attempt of someone you know will touch your life, if it has not already done so. If you have a friend who appears deeply depressed, is preoccupied with death, begins to give away prized possessions, or talks openly about suicide, take the signs seriously. Encourage the

Suicide

Symptoms of Depression

One symptom of depression is the diminished abil-ity to think or concentrate. This student has difficulty concentrating on her schoolwork.

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chance of developing depression. The odds are significantly higher for identical twins (who have identical genes because they develop from a single fertilized egg cell). If one identical twin has major depressive disorder, the second twin’s chances rise to about 50 percent. The trend is even more pronounced for bipolar disorder, with the second identical twin having a 70 percent chance of developing bipolar disorder if the first twin has it (Tsuang & Faraone, 1990). Note, however, that genes do not determine the disorder. For major depressive disorder, 50 percent of identical twins do not develop the condition if their twin has the

person to seek help immediately (one option is to call the National Suicide Prevention Hotline, available toll- free 24 hours a day at 1- 800- 273- TALK) and consult with a parent, teacher, counselor, physician, or reli-gious leader to make sure you have done all that you can. If you begin to feel suicidal, seek help. The dark mood will lift, and better days do lie ahead.

Nearly a million people worldwide commit suicide each year (World Health Organization, 2008d). Consider these differences in suicide rates for different groups:

● In general, Western countries have a higher rate of suicide than non- Western countries, but there is great variation even among Western countries. The rate in England is about half the U.S. rate, and the rate in Finland is about double (World Health Organiza-tion, 2008d).

● In most parts of the world, men are more likely than women to commit suicide. Women, however, are

at least twice as likely to attempt suicide. Men suc-ceed more often because their method of choice is firearms, which are more lethal than the drug over-doses preferred by women (World Health Organi-zation, 2008d).

● White Americans have a higher suicide rate than other racial groups (National Institute of Mental Health, 2002).

● Suicide rates increase with age. The highest rate of suicide is among older men (see Figure 31.5).

● Suicide rates have been increasing over time. For 15- to 25- year- olds, the suicide rate doubled between 1960 and 1990 (Eckersley & Dear, 2002).

● There is a strong link between drug and alcohol use and suicide. The risk of suicide is 100 times greater among those dependent upon alcohol (Murphy & Wetzel, 1990).

50

60

70

10

20

30

40

0

U.S. suicides per100,000 people

15–24 25–345–14 35–44Age in years

45–54 55–64 65–74 75+

Males

Men’s already high suiciderate further increasesin late adulthood

Females

Figure 31.5

Suicide, Gender, and Age

Suicide is more com-mon among men than women at all ages. Elderly males have the highest rate of sui-cide. (From Statistical Abstracts, 2008.)


563

31

DifferentiationRemind students that being geneti-cally predisposed to a condition such as depression does not mean one is guaranteed to get the disorder. Genetic predisposition combined with the right environmental circumstances can help a person avoid the symptoms or inci-dence of disorder.


Biological Factors Our physical and psychological future is not written in our genes, but genetics does set limits on some of our choices. For mood disorders, both heredity and brain function appear to be important biologi-cal factors.

● Heredity— Many disorders run in families, and mood disorders are no exception. We can see the influence of heredity in twin studies. Geneti-cally, fraternal twins (who develop from two fertilized egg cells) differ from each other as much as any other two siblings. If one fraternal twin has major depressive disorder, the other twin has a 20 percent

Psychology in T H E R E A L W O R L D

When I was a junior in high school, back in the late 1960s, a fellow student didn’t appear for class one day shortly after breaking up with a longtime girl-friend. As the day wore on, rumors that he had com-mitted suicide began to travel through the student body. The rumors proved to be true, but nobody ever dealt with the issue openly. Teachers, counselors, administrators, and parents seemed united in their desire not to talk about something they found dis-turbing and unexplainable. Students were left to sort out their questions and feelings on their own, and the school never even issued an official acknowledgment of what had happened.

There have also been student suicides, and suicide attempts, in the school where I now teach. Seeing this important issue brought into the open has been gratify-ing. In recent years, the administration put into place a crisis response plan to help both students and faculty members cope with the emotional effect of the loss or injury of a student. Instead of pretending that noth-ing has happened, the school issues announcements, runs articles in the school newspaper, and ensures that counselors are available to help friends and class-mates with their grief and questions. Bringing the topic of suicide into the light of day may prevent others from making this tragic choice.

One interesting fact about suicide is that people who are deeply depressed rarely kill themselves until after the depression starts to lift. This is confusing to friends, because the suicide occurs just as the per-son seems to be getting better. Ironically, this lifting of depression gives the person the energy to execute a

plan developed when depression was so overwhelm-ing that it effectively stopped action.

For adolescents, to have occasional, passing thoughts of suicide is neither unusual nor a cause for concern. But becoming obsessed with thoughts of suicide, or starting to develop plans for commit-ting suicide, is. It’s quite likely that a suicide or suicide attempt of someone you know will touch your life, if it has not already done so. If you have a friend who appears deeply depressed, is preoccupied with death, begins to give away prized possessions, or talks openly about suicide, take the signs seriously. Encourage the

Suicide

Symptoms of Depression

One symptom of depression is the diminished abil-ity to think or concentrate. This student has difficulty concentrating on her schoolwork.

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DifferentiationRemind students that being genetically predisposed to a condition such as depression does not mean one is guaranteed to get the disorder. Genetic predisposition combined with the right environmental circumstances can help a person avoid the symptoms or incidence of disorder.


chance of developing depression. The odds are significantly higher for identical twins (who have identical genes because they develop from a single fertilized egg cell). If one identical twin has major depressive disorder, the second twin’s chances rise to about 50 percent. The trend is even more pronounced for bipolar disorder, with the second identical twin having a 70 percent chance of developing bipolar disorder if the first twin has it (Tsuang & Faraone, 1990). Note, however, that genes do not determine the disorder. For major depressive disorder, 50 percent of identical twins do not develop the condition if their twin has the

person to seek help immediately (one option is to call the National Suicide Prevention Hotline, available toll- free 24 hours a day at 1- 800- 273- TALK) and consult with a parent, teacher, counselor, physician, or reli-gious leader to make sure you have done all that you can. If you begin to feel suicidal, seek help. The dark mood will lift, and better days do lie ahead.

Nearly a million people worldwide commit suicide each year (World Health Organization, 2008d). Consider these differences in suicide rates for different groups:

● In general, Western countries have a higher rate of suicide than non- Western countries, but there is great variation even among Western countries. The rate in England is about half the U.S. rate, and the rate in Finland is about double (World Health Organiza-tion, 2008d).

● In most parts of the world, men are more likely than women to commit suicide. Women, however, are

at least twice as likely to attempt suicide. Men suc-ceed more often because their method of choice is firearms, which are more lethal than the drug over-doses preferred by women (World Health Organi-zation, 2008d).

● White Americans have a higher suicide rate than other racial groups (National Institute of Mental Health, 2002).

● Suicide rates increase with age. The highest rate of suicide is among older men (see Figure 31.5).

● Suicide rates have been increasing over time. For 15- to 25- year- olds, the suicide rate doubled between 1960 and 1990 (Eckersley & Dear, 2002).

● There is a strong link between drug and alcohol use and suicide. The risk of suicide is 100 times greater among those dependent upon alcohol (Murphy & Wetzel, 1990).

50

60

70

10

20

30

40

0

U.S. suicides per100,000 people

15–24 25–345–14 35–44Age in years

45–54 55–64 65–74 75+

Males

Men’s already high suiciderate further increasesin late adulthood

Females

Figure 31.5

Suicide, Gender, and Age

Suicide is more com-mon among men than women at all ages. Elderly males have the highest rate of sui-cide. (From Statistical Abstracts, 2008.)

Suicide in Other CulturesHave students investigate reasons why suicide rates differ among different cultures.

● Do some cultures view suicide as an honorable way of ending life?● What about Finnish culture seems to encourage suicide? What about British culture

discourages it?

At this point, you may want to use Critical Thinking Activity: The Revised Facts on Suicide Quiz.

MuLticuLturAL connections TRM

Helping Loved OnesHave students divide into groups and come up with several serious, helpful responses they might give to a friend, a family member, or an acquaintance who communi-cates that he or she is contemplat-ing suicide. Have them consider the following questions:

● What would their response be to someone who seemed preoc-cupied with death?

● What would their response be to someone who tried to give them a prized possession?

● What would they say to some-one who told them he or she was contemplating suicide?

At this point, you may want to use Analysis Activity: The Body Investment Scale and Self-Mutilation and Enrichment Lesson: Self-Mutilation.

Active LeArning TRM


564

31

Beyond the ClassroomGuest Speaker Invite a psychologist to class who specializes in treating mood disorders.

● What method or methods of treat-ment does he or she prefer?

● What current research is being done on mood disorders?

● What are the rates of mood disor-ders among high school students?

Invite a psychologist to class who specializes in treating mood

What current research is being done


disorder. For bipolar disorder, 30 percent do not develop it if the other twin has it.

● Brain function— Depressed people have depressed brains (see Figure

31.6). Positive emission tomography (PET) scan studies indicate that the brain is less active during major depression, especially in frontal lobe regions that are normally active during positive emotions (David-son et al., 2002). It is also true that certain neurotransmitters— the chemical messengers that allow individual neurons in the brain to com-municate with one another— appear to be out of balance in the case of mood disorders. The two neurotransmitters that are most important for depression are serotonin and norepinephrine, which are lacking during times of depression. The levels of these neurotransmitters may ultimately be controlled by genes. People who experience major stress are much more likely to develop depression if there is a problem with a gene that controls serotonin levels (Moffitt et al., 2006). Prozac and other antidepressant medications help restore the proper levels of these neurotransmitters.

Social- Cognitive Factors Psychologists operating from the biologi-cal and cognitive perspectives have made tremendous progress in explain-ing behavior and mental processes in recent years. In addition to the biological influences described in the previous paragraphs, researchers have identified a number of important social and cognitive influences. Psychologists look closely at the interplay among the way we think, the situations we find ourselves in, and the way we feel. These social and cog-nitive factors actually affect brain chemistry and are affected by it. Com-plicated? Yes, but mood disorders are complex, and we would be unreal-istic to expect simple explanations for these conditions. Consider a few social- cognitive influences:

● Learned helplessness— People develop a sense of helplessness when sub-jected to unpleasant events over which they have little or no control. As they acquire this feeling of helplessness, they give up and no longer try to improve their situation because they learned in the past that efforts to improve the situation will not work. This alone can produce depression. Learned helplessness may be one reason women suffer higher rates of depression than men do. Compared with men, women

Figure 31.6

Bipolar Disorder and Brain Scans

These PET scans show that mood and brain activity are correlated. The yellow and red areas of the middle scan indicate that the brain is more active during the manic phase of bipolar disorder.

Depressed state(May 17)

Manic state(May 18)

Depressed state(May 27) c

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are more likely to be abused, stressed, and overwhelmed (Hankin & Abramson, 2001; Mazure et al., 2002).

● Attributions— When things go wrong, we try to explain them. Your explanatory style is determined by the nature of the explanations, or attributions, that you make. These attributions can vary from person to person. It turns out that depressed people are likely to make attribu-tions with the following characteristics (see Figure 31.7):

● Stable— The bad situation will last a long time.

● Internal— This happened because of my actions, not because of the actions of someone else and not because of the circumstances.

● Global— My explanation applies to many areas of my life.

If I fail a history test and explain this by saying, “I’m stupid,” I’ve met all these conditions. This attribution is stable (stupidity doesn’t come and go; it stays with me), internal (stupidity is a personal characteristic), and global (being stupid affects most of the things I do). One theory (Abramson et al., 1989; Panzarella et al., 2006) says that these attributions lead to a sense of hopelessness that produces depression.

Notice that this sense of hopelessness is less likely if attributions change. If I say I failed a history test because I was sick that day, even though being sick is internal and global, my explanation is not stable (I haven’t said I’ll

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Internal

“It was all my fault.”

Stable

“I am a bad person.”Associated With

Depression

Not AssociatedWith Depression

WHY WERE YOU FIRED?

Global

“I mess everything up.”

External

“Yesterday was areally bad day.”

Not Stable

“I say things I don’tmean when I’m tired.”

Specific

“I make mistakeswhen I rush.”

Figure 31.7

Attributions and Depression

How we explain events— such as losing a job— is associated with depression. People with depression are likely to explain events with stable, internal, and global statements.

Learned Helplessness

When people find themselves in unpleasant situations over which they have little con-trol (like this woman doing tedious, poorly paid factory work), learned helplessness can set in. This, in turn, is associated with depression.

ResearchHave students research how drug use could affect the diagnosis of a mood disorder.

● Does the DSM make any spe-cial category for drug- induced mood disorders? (Yes, mood disorders caused by substance abuse reside in another diagnos-tic category.)

● How might a doctor tell the difference between a mood disorder and a substance- abuse mood disorder?

● What other disorders might drug use cause?

Active LeArning

ArtInvite your school’s art teacher to class to discuss how the creative genius of several famous artists might have been their outlet for a mental illness.

● Does having a mental illness seem to diminish the quality of the art in the minds of viewers or critics?

● How does the teacher define creativity? Does that definition sound similar to mania?

At this point, you may want to use Enrichment Lesson: Commitment to the Common Good.

cross- curricuLAr connection TRM


565

31TeaChing TiP TRMLink the terms stable, internal, and global to learned optimism:

● Stable = permanent Pessimists believe that bad events will become a permanent fixture in their lives.

● Internal = personal Pessimists believe that bad events are a result of some personal flaw that cannot be changed.

● Global = pervasive Pessimists believe that a bad experience in one area of life will influence other areas and cause havoc throughout one’s life.

At this point, you may want to use Enrichment Lesson: Cognitive Errors in Depression.

Beyond the ClassroomBrainstorm Attribution and learned helplessness help explain depres-sion, but what about explanations for mania? Have students brainstorm about different psychological explana-tions for mania.

● How might learning theorists explain mania?

● What attributions might a manic make about his or her behavior? Would the person be optimistic or pessimistic?


disorder. For bipolar disorder, 30 percent do not develop it if the other twin has it.

● Brain function— Depressed people have depressed brains (see Figure

31.6). Positive emission tomography (PET) scan studies indicate that the brain is less active during major depression, especially in frontal lobe regions that are normally active during positive emotions (David-son et al., 2002). It is also true that certain neurotransmitters— the chemical messengers that allow individual neurons in the brain to com-municate with one another— appear to be out of balance in the case of mood disorders. The two neurotransmitters that are most important for depression are serotonin and norepinephrine, which are lacking during times of depression. The levels of these neurotransmitters may ultimately be controlled by genes. People who experience major stress are much more likely to develop depression if there is a problem with a gene that controls serotonin levels (Moffitt et al., 2006). Prozac and other antidepressant medications help restore the proper levels of these neurotransmitters.

Social- Cognitive Factors Psychologists operating from the biologi-cal and cognitive perspectives have made tremendous progress in explain-ing behavior and mental processes in recent years. In addition to the biological influences described in the previous paragraphs, researchers have identified a number of important social and cognitive influences. Psychologists look closely at the interplay among the way we think, the situations we find ourselves in, and the way we feel. These social and cog-nitive factors actually affect brain chemistry and are affected by it. Com-plicated? Yes, but mood disorders are complex, and we would be unreal-istic to expect simple explanations for these conditions. Consider a few social- cognitive influences:

● Learned helplessness— People develop a sense of helplessness when sub-jected to unpleasant events over which they have little or no control. As they acquire this feeling of helplessness, they give up and no longer try to improve their situation because they learned in the past that efforts to improve the situation will not work. This alone can produce depression. Learned helplessness may be one reason women suffer higher rates of depression than men do. Compared with men, women

Figure 31.6

Bipolar Disorder and Brain Scans

These PET scans show that mood and brain activity are correlated. The yellow and red areas of the middle scan indicate that the brain is more active during the manic phase of bipolar disorder.

Depressed state(May 17)

Manic state(May 18)

Depressed state(May 27) c

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F le

Wis

Ba

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TeaLink the terms global

●

●

●

use Errors in Depression.

Beyond the ClassroomBrainstormhelplessness help explain depression, but what about explanations for mania? Have students brainstorm about different psychological explanations for mania.

●

●


are more likely to be abused, stressed, and overwhelmed (Hankin & Abramson, 2001; Mazure et al., 2002).

● Attributions— When things go wrong, we try to explain them. Your explanatory style is determined by the nature of the explanations, or attributions, that you make. These attributions can vary from person to person. It turns out that depressed people are likely to make attribu-tions with the following characteristics (see Figure 31.7):

● Stable— The bad situation will last a long time.

● Internal— This happened because of my actions, not because of the actions of someone else and not because of the circumstances.

● Global— My explanation applies to many areas of my life.

If I fail a history test and explain this by saying, “I’m stupid,” I’ve met all these conditions. This attribution is stable (stupidity doesn’t come and go; it stays with me), internal (stupidity is a personal characteristic), and global (being stupid affects most of the things I do). One theory (Abramson et al., 1989; Panzarella et al., 2006) says that these attributions lead to a sense of hopelessness that produces depression.

Notice that this sense of hopelessness is less likely if attributions change. If I say I failed a history test because I was sick that day, even though being sick is internal and global, my explanation is not stable (I haven’t said I’ll

Jaim

e p

ue

Bla

/ap

/Wid

e W

or

ld p

ho

Tos

Internal

“It was all my fault.”

Stable

“I am a bad person.”Associated With

Depression

Not AssociatedWith Depression

WHY WERE YOU FIRED?

Global

“I mess everything up.”

External

“Yesterday was areally bad day.”

Not Stable

“I say things I don’tmean when I’m tired.”

Specific

“I make mistakeswhen I rush.”

Figure 31.7

Attributions and Depression

How we explain events— such as losing a job— is associated with depression. People with depression are likely to explain events with stable, internal, and global statements.

Learned Helplessness

When people find themselves in unpleasant situations over which they have little con-trol (like this woman doing tedious, poorly paid factory work), learned helplessness can set in. This, in turn, is associated with depression.


566

31ReteachUse Figure 31.8 to emphasize the interaction of multiple factors in mood disorders. Students should see that while mood disorders are often treated with medications, medications alone do not address the social and cognitive factors that contribute to the disorder. An eclectic approach is important to sustaining mental health.

interaction of multiple factors in mood

while mood disorders are often treated

do not address the social and cognitive factors that contribute to the disorder.


always be sick). Thus, I’m less likely to feel hopeless and depressed. If I say I failed the history test because I have a bad teacher, my attribution is not internal— I haven’t taken personal responsibility. Again, I avoid depression. Teaching people to change their attributions can be an effective way of treat-ing depression.

All these factors, biological and social- cognitive, can interact to form a vicious cycle of depression (see Figure 31.8). A person’s heredity might pre-dispose depression by allowing the balance of neurotransmitters to operate in a range associated with mood disorders or by “programming” the brain to function differently. The environment might be stressful and full of situ-ations over which a person has little control. This might produce learned helplessness and discouragement, which— combined with attributions that are stable, global, and internal— pave the way to mood disorders. It is pos-sible that the mood disorders, environmental conditions, or the way a person thinks can produce further alterations of brain chemistry and function, mak-ing negative thinking and emotions even more likely in the future. These fac-tors, working together, become a psychological trap.



In this module, we examined two of the more common categories of psycho-logical disorders: anxiety disorders and mood disorders. According to some estimates, roughly one- quarter of us will experience a disorder from one of these two broad categories at some point in life (Robins & Regier, 1991). Researchers have begun to unravel the complicated story of what causes anxiety and mood disorders. As they continue to make progress, even more effective treatment options will become available to help those who suffer from these widespread conditions.

Real-WorldEvents

Mood

Cognition: TheWay We Think

BrainChemistry

Figure 31.8

What Determines Mood?

Mood flows from a complex interaction of biological and social- cognitive factors. These factors influence one another and are influenced by external events and internal moods. Attempts to improve mood can focus on controlling the environment, prescribing medications to change brain chemistry, or changing the way the person thinks.


Anxiety Disorders

WHAT’S THE POINT?


● Generalized anxiety disorder is marked by dis-ruptive levels of persistent, unexplained feelings of apprehension and tenseness.

● Panic disorder is marked by sudden bouts of intense, unexplained panic.

● Phobia is marked by disruptive, irrational fears of objects, activities, or situations.

● Obsessive- compulsive disorder is marked by unwanted, repetitive thoughts and actions. Obsessions are repetitive thoughts. Compulsions are repetitive actions.

● Post- traumatic stress disorder is characterized by reliving a severely upsetting event in unwanted, recurring memories and dreams.

● Several biological factors may contribute to anxiety disorders, including heredity and brain function as well as evolution and natural selection.

● People may learn maladaptive responses that can blossom into anxiety disorders. These include associating fear with certain places or things (conditioning), learning fear or anxiety responses by watching others experience them (observational learning), and learning to asso-ciate emotions with actions and the results that follow those actions (reinforcement or punishment).

Apply What You Know

1. All of a sudden, Roberto started sweating, his heart started racing, and he felt like he couldn’t breathe. Which of the following fits Roberto’s symptoms best?

a. panic disorder b. social phobia c. post- traumatic stress disorder d. obsessive- compulsive disorder

2. A person with a(n) __________ might wash his or her hands 100 times each day.

3. Baghya fears flying and feels relieved whenever she can avoid traveling by air. This is an exam-ple of how phobias can be influenced by

a. observational learning. b. reinforcement. c. heredity. d. evolution.

4. True or False: Obsessive- compulsive disorder produces increased activity in the rear of the brain.

Mood Disorders

WHAT’S THE POINT?


● Major depressive disorder is diagnosed when five of the following nine symptoms (including one of the first two) are present for two or more weeks: depressed mood most of the day, little interest in activities, changes in appetite, changes in sleep, changes in activity level, fatigue, feelings of worthlessness, inability to concentrate, and recurrent thoughts of suicide.

● People with bipolar disorder alternate between the hopelessness of depression and the overex-cited and unreasonably optimistic state of mania.

● Several biological factors may contribute to anxiety disorders, including heredity and brain function.

● Researchers have identified a number of impor-tant social and cognitive influences on the devel-opment of mood disorders, including the way we think (attributions) and the situations in which we find ourselves (as with learned helplessness).

Apply What You Know

5. Avin came out of a period of intense depression but now goes days without sleeping, has racing

SuMMARY AND FORMATiVe ASSeSSMeNTMODULE 31Thinking About Anxiety and Mood Disorders

ResearchHave students research which neurotransmitters are most related to both anxiety and mood disorders. Extend the research to include the types of drugs used to treat these conditions. Have students discover how the drugs act on the neural sites to affect behavior.

Active LeArning

Understanding Social- Cognitive FactorsHave students imagine that their checking account is overdrawn. Ask:

● Does this explanation reflect something about you (internal) or something about other peo-ple or circumstances (external)?

● Is it something that is perma-nent (stable) or temporary (unstable)?

● Does it influence other areas of your life (global) or only your checking account balance (specific)?

Reiterate that internal, stable, and global attributions tend to be associated with depression.

Active LeArning


567

31assess

Check for Understanding TRMAt this point, you may wish to review and confirm concepts about anxiety and mood disorders with Critical Thinking Activity: Fact or False-hood? Suggest that students complete the handout in small groups, taking the time to look up information in the text to respond correctly to questions. Have all the groups meet to review the handout, again asking students to use the text to support their responses.

CLose

ReteachThis module focused on two of the most common psychological disorders: anxiety and mood disorders. In the right balance, anxiety and mood are adaptive and beneficial. Out of bal-ance, they can have dramatic negative effects on one’s daily life. Have stu-dents create a chart with two columns: one column labeled “Benefits/Needs Met” and the other column labeled “Drawbacks/Hindrances.” Ask students to brainstorm about how the levels of anxiety and types of moods can be beneficial or detrimental in their lives.

answers Anxiety Disorders: Apply What You Know

1. (a)

2. compulsion

3. (b)

4. False


always be sick). Thus, I’m less likely to feel hopeless and depressed. If I say I failed the history test because I have a bad teacher, my attribution is not internal— I haven’t taken personal responsibility. Again, I avoid depression. Teaching people to change their attributions can be an effective way of treat-ing depression.

All these factors, biological and social- cognitive, can interact to form a vicious cycle of depression (see Figure 31.8). A person’s heredity might pre-dispose depression by allowing the balance of neurotransmitters to operate in a range associated with mood disorders or by “programming” the brain to function differently. The environment might be stressful and full of situ-ations over which a person has little control. This might produce learned helplessness and discouragement, which— combined with attributions that are stable, global, and internal— pave the way to mood disorders. It is pos-sible that the mood disorders, environmental conditions, or the way a person thinks can produce further alterations of brain chemistry and function, mak-ing negative thinking and emotions even more likely in the future. These fac-tors, working together, become a psychological trap.



In this module, we examined two of the more common categories of psycho-logical disorders: anxiety disorders and mood disorders. According to some estimates, roughly one- quarter of us will experience a disorder from one of these two broad categories at some point in life (Robins & Regier, 1991). Researchers have begun to unravel the complicated story of what causes anxiety and mood disorders. As they continue to make progress, even more effective treatment options will become available to help those who suffer from these widespread conditions.

Real-WorldEvents

Mood

Cognition: TheWay We Think

BrainChemistry

Figure 31.8

What Determines Mood?

Mood flows from a complex interaction of biological and social- cognitive factors. These factors influence one another and are influenced by external events and internal moods. Attempts to improve mood can focus on controlling the environment, prescribing medications to change brain chemistry, or changing the way the person thinks.

Check for Understanding At this point, you may wish to review and confirm concepts about anxiety and mood disorders with Thinkinghood?the handout in small groups, taking the time to look up information in the text to respond correctly to questions. Have all the groups meet to review the handout, again asking students to use the text to support their responses.

ReteachThis module focused on two of the most common psychological disorders: anxiety and mood disorders. In the right balance, anxiety and mood are adaptive and beneficial. Out of balance, they can have dramatic negative effects on one’s daily life. Have students create a chart with two columns: one column labeled “Benefits/Needs Met” and the other column labeled “Drawbacks/Hindrances.” Ask students to brainstorm about how the levels of anxiety and types of moods can be beneficial or detrimental in their lives.

aWhat You Know


Anxiety Disorders

WHAT’S THE POINT?


● Generalized anxiety disorder is marked by dis-ruptive levels of persistent, unexplained feelings of apprehension and tenseness.

● Panic disorder is marked by sudden bouts of intense, unexplained panic.

● Phobia is marked by disruptive, irrational fears of objects, activities, or situations.

● Obsessive- compulsive disorder is marked by unwanted, repetitive thoughts and actions. Obsessions are repetitive thoughts. Compulsions are repetitive actions.

● Post- traumatic stress disorder is characterized by reliving a severely upsetting event in unwanted, recurring memories and dreams.

● Several biological factors may contribute to anxiety disorders, including heredity and brain function as well as evolution and natural selection.

● People may learn maladaptive responses that can blossom into anxiety disorders. These include associating fear with certain places or things (conditioning), learning fear or anxiety responses by watching others experience them (observational learning), and learning to asso-ciate emotions with actions and the results that follow those actions (reinforcement or punishment).

Apply What You Know

1. All of a sudden, Roberto started sweating, his heart started racing, and he felt like he couldn’t breathe. Which of the following fits Roberto’s symptoms best?

a. panic disorder b. social phobia c. post- traumatic stress disorder d. obsessive- compulsive disorder

2. A person with a(n) __________ might wash his or her hands 100 times each day.

3. Baghya fears flying and feels relieved whenever she can avoid traveling by air. This is an exam-ple of how phobias can be influenced by

a. observational learning. b. reinforcement. c. heredity. d. evolution.

4. True or False: Obsessive- compulsive disorder produces increased activity in the rear of the brain.

Mood Disorders

WHAT’S THE POINT?


● Major depressive disorder is diagnosed when five of the following nine symptoms (including one of the first two) are present for two or more weeks: depressed mood most of the day, little interest in activities, changes in appetite, changes in sleep, changes in activity level, fatigue, feelings of worthlessness, inability to concentrate, and recurrent thoughts of suicide.

● People with bipolar disorder alternate between the hopelessness of depression and the overex-cited and unreasonably optimistic state of mania.

● Several biological factors may contribute to anxiety disorders, including heredity and brain function.

● Researchers have identified a number of impor-tant social and cognitive influences on the devel-opment of mood disorders, including the way we think (attributions) and the situations in which we find ourselves (as with learned helplessness).

Apply What You Know

5. Avin came out of a period of intense depression but now goes days without sleeping, has racing

SuMMARY AND FORMATiVe ASSeSSMeNTMODULE 31Thinking About Anxiety and Mood Disorders

Exploring Psychological Disorders on the World Wide WebStudents can search the web for information on different disorders presented in Modules 30 through 32. Assign each student or group of students a disorder and have them gather information on it, creating a presentation to share with the class, school, or community. Some presentation options include the following:

● A formal research paper● A poster presentation● A public awareness campaign to educate people about the illness● A documentary about someone with the disorder that educates people about the day- to-

day life of people with the illness

Please refer to Alternative Assessment/Portfolio Project: Exploring Psychological Disorders on the World Wide Web for helpful websites and rubrics to aid in evaluating your students’ projects.

PortFoLio Project TRM


568

31Using the Test BankThe Test Bank that accompanies this textbook offers a wide variety of ques-tions in different formats and levels of complexity. Use the software to construct whole tests or to integrate standardized questions into teacher- made tests.

answers Mood Disorders: Apply What You Know

5. (b)

6. social- cognitive

7. Learned helplessness

8. True

Mood Disorders: Apply What


thoughts, and sets impossible goals for himself. He may be experiencing

a. an anxiety disorder with mood swings. b. the manic phase of bipolar disorder. c. post- traumatic stress disorder. d. the major phase of his major depressive

episode.

6. Psychologists studying the development of mood disorders who look for the effects of the

way we think, the situations we find ourselves in, and the way we feel are searching for __________ factors that may influence the devel-opment of a mood disorder.

7. __________ may occur when we are exposed to unpleasant events over which we have little or no control.

8. True or False: Depressed people make attribu-tions that are stable, internal, and global.

anxiety, p. 550

generalized anxiety disorder, p. 551

panic disorder, p. 551

phobia, p. 551

obsessive- compulsive disorder (OCD), p. 551

post- traumatic stress disorder (PTSD), p. 551

major depressive disorder, p. 560

bipolar disorder, p. 561

K e y T e r m s


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