myers’ psychology psychological disorders5) post traumatic stress disorder (ptsd) follows a...

Myers’ PSYCHOLOGY

Psychological Disorders

James A. McCubbin, PhD

Clemson University

Worth Publishers

David Rosenhan suspected that terms such as sanity,

insanity, schizophrenia, mental illness, and abnormal might

have fuzzier boundaries that the psychiatric community

thought.

He also suspected that some strange behaviors seen in

mental patients might originate in the abnormal

atmosphere of the mental hospital, rather than the patients

themselves. Education

･AB, Yeshiva College, 1951

･MA, Columbia University,

･PhD (psychology),

Columbia University, 1958

Professor, Stanford

University

Dangers of Labeling David Rosenhan

Being Sane in Insane Places

In 1973 sociologist David Rosenhan designed a clever

study to examine the difficulty that people have shedding the

"mentally ill" label. He was particularly

interested in how staffs in mental

institutions process information about

patients.

Rosenhan & seven associates had themselves

committed to different mental hospitals

complaining of hearing voices. All but one were

diagnosed as schizophrenic.

•Once admitted, they acted totally normal.

•Remained hospitalized for average 19 days (9 to

•Only the patients detected their sanity

•When discharged their chart read,

“schizophrenia in remission”

No professional staff member at

any of the hospitals ever realized

that any of Rosenhan’s

pseudopatients was a fraud.

According to a study conducted by the National

Institute of mental health:

*15.4% of the population suffers from diagnosible

mental health problems

*56 million Americans meet the criteria for a

diagnosible psychological disorder (Carson 1996, Regier

*Over the lifespan, +/- 32% of Americans will suffer

from some psychological disorder. (Regier1988)

Normal or Abnormal?

Not easy task:

*Is Robin Williams normal?

Marilyn Manson?

*Is a soldier who risks his life

or her life in combat normal?

*Is a grief-stricken woman

unable to return to her

routine three months after

her husband died normal?

Is a man who climbs

mountains as a hobby

normal?

Some abnormalities are easy:

Hallucinations (false sensory experiences)

Delusions (extreme disorders of thinking)

Affective problems (emotion: depressed, anxious,

or lack of emotion)

CORE CONCEPT:

Medical model: takes a “disease” view

Psychology model: interaction of biological, mental, social,

and behavioral factors

Psychological Disorder

– a “harmful dysfunction” in which behavior is judged to be:

• atypical- (not enough in itself)

• disturbing- (varies with time & culture)

• maladaptive- (harmful)

• unjustifiable- (sometimes there’s a good reason)

THE WORLD OF ABNORMAL

BEHAVIOR:

#1 Looking at Abnormal Behavior

#2 The Nature of Stress

Carol D. Ryff argues that we must define mental illness

in terms of the positive. She names 6 core

dimensions:

1) Self-acceptance:

positive attitude towards self

multiple aspects of self

positive about past life

2) Positive self relations with other people:

warm, trusting, satisfying interpersonal relationships

capable of empathy, affection, intimacy

3) Autonomy

independent, self-determined

able to resist social pressures

4) Environmental mastery:

sense of mastery and competence

makes good use of opportunities

creates contexts that support their personal needs

5) Purpose of Life:

has goals and directedness

feels there is meaning to past and present life

6) Personal Growth:

see oneself as growing and expanding

open to new experiences

change in ways that reflect self-knowledge and

effectiveness

Historical Perspective

Perceived Causes

*movements of sun or moon

*lunacy- full moon

*demons & evil spirits

Ancient Treatments

*exorcism, caged like animals, beaten,

burned, castrated, mutilated, blood

replaced with animal’s blood

Historical Perspective

Hippocrates (400 bc) *first step in scientific view of mental disturbance.

*imbalance (excess) among four body fluids called “humors”

Humors Origin Temperament

Blood heart sanguine (cheerful)

Choler (yellow bile) liver choleric (angry)

Melancholer spleen melancholy (depressed)

(black bile)

Phlegm brain phlegmatic (sluggish)

Medical Model

*concept that diseases have physical causes

*can be diagnosed, treated, and in most cases, cured

*assumes that these “mental” illnesses can be diagnosed on the basis of their symptoms and cured through therapy, which may include treatment in a psychiatric hospital

Bio-psycho-social

Perspective

*assumes that biological,

sociocultural, and

psychological factors

combine and interact to

produce psychological

disorders

Biological

(Evolution,

individual

genes, brain

structures

and chemistry)

Psychological

(Stress, trauma,

learned helplessness,

mood-related perceptions

and memories)

Sociocultural

(Roles, expectations,

definition of normality

and disorder)

Psychological Disorders- Etiology

DSM-IV-TR

*American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition)

*a widely used system for classifying psychological disorders

*presently distributed as DSM-IV-TR (text revision)

*today used as “convenient shorthand” to avoid labeling.

DSM-IV-TR organizes each psychiatric diagnosis into five levels (axes) relating to different aspects of the disorder or disability:

1) Axis 1 -- Clinical disorders including major mental disorders, as well as developmental or learning problems. Common disorders in this category include depression, bipolar, anxiety, ADHD, and schizophrenia.

2) Axis 2 -- Pervasive or personality disorders, including mental retardation. Common disorders in this category include borderline PD, schizotypal PD, narcissistic PD, antisocial PD, paranoid PD.

DSM-IV-TR continued:

3) Axis 3 -- Acute medical conditions and physical disorders. Common disorders in this category include brain trauma, brain injury, brain disease..

4) Axis 4 -- Psychosocial and environmental factors contributing to the disorder. Common factors in this category include a man suffering from depression after losing his job, or his wife dying, et. al.

5) Axis 5 -- Global Assessment of Functioning or Children’s Global Assessment Scale (under 18)

Additions to DSM-IV

The Insanity Defense

Psychological Disorders- Etiology

Neurotic disorder (term seldom used now)

*usually distressing but that allows one to think

rationally and function socially

*Freud saw the neurotic disorders as ways of

dealing with anxiety

Psychotic disorder

*person loses contact with reality

*experiences irrational ideas and distorted

perceptions

PREPAREDNESS HYPOTHESIS:

Suggests that we have an innate biological

tendency, acquired through natural selection, to

respond quickly and automatically to stimulti

that posed a survival threat to our ancestors.

(Ohman & Mineka, 2001)

This explains why we

develop phobias for

snakes and lightening

more easily than others.

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•ANXIETY DISORDERS

•MOOD DISORDERS

•DISSOCIATIVE DISORDERS

•SCHIZOPHRENIA

•PERSONALITY DISORDERS

•BIOPSYCHOSOCIAL DISORDERS

•SUBSTANCE ABUSE DISORDERS

•SEXUAL DISORDERS

•DEVELOPMENTAL (CHILDHOOD)

DISORDERS

ANXIETY

DISORDERS

1) PANIC DISORDER w/AGORAPHOBIA

2) GENERALIZED ANXIETY DISORDER

3) PHOBIAS

a) simple

b) social

c) agoraphobia

4) OBSESSIVE-COMPULSIVE DISORDER (OCD)

5) POST TRAUMATIC STRESS DISORDER (PTSD)

6) SOMOTOFORM

a) hypochondria

b) conversion (hysteria)

Anxiety Disorders

*distressing, persistent anxiety or maladaptive behaviors that reduce anxiety

Anxiety Disorders 1) Panic Disorder

*marked by a minutes-long episode of intense dread in

which a person experiences terror and accompanying

chest pain, choking, racing heart, sweating, muscle-

spasms, or other frightening sensations

*common thinking patterns include:

"I’m losing control.....”

"I feel like I’m going crazy.....”

"I must be having a heart attack.....”

"I’m smothering and I can’t breathe.....”

1a) Panic Disorder w/Agoraphobia

*fear of leaving home for fear of having a panic attack

2) Generalized Anxiety Disorder

person is tense, apprehensive, and in a state of autonomic nervous system arousal

*Chronic (6 months) unrealistic or excessive worry

about 2 or more elements in one’s life.

3) Phobias

a) Simple

Excessive, irrational fear of objects or situations

b) Social

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

c) Agoraphobia

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

Anxiety Disorders Phobias

persistent, irrational fear of a specific object or situation

Ablutophobia: washing, bathing

Acrophobia: heights

Algophobia: pain

Arachibutyrophobia: peanut butter

sticking to roof of mouth

Caligynephobia: beautiful women

Cleptophobia: stealing

Demophobia: crowds

Ecclesiophobia: church

Ergophobia: work

Genophobia: sex

Gynephobia: women

Ichthyophobia: fish

Lutraphobia: otters

Macrophobia: long waits

Medorthophobia: erect penis

Parthenophobia: virgins

Pophyrophobia: color purple

Somniphobia: sleep

Testophobia: taking a test

Anxiety Disorders Common and uncommon fears

Afraid of it Bothers slightly Not at all afraid of it

closed in,

at night

Percentage

of people

surveyed

Snakes Being

in high,

exposed

places

Mice Flying

airplane

Spiders

insects

Thunder

lightning

Dogs Driving

of people

Anxiety Disorders

4) Obsessive-Compulsive Disorder *unwanted repetitive thoughts (obsessions) and/or actions (compulsions)

*feel obsessed w/something they do not want to think about and/or

compelled to carry out some action, often pointlessly ritualistic.

*1 in 50 adults has OCD

*Exact pathophysiologic process that underlies OCD has not been

established.

*Research suggests that abnormalities in serotonin (5-HT)

transmission in the central nervous system are central to this

disorder.

*Supported by the efficacy of specific serotonin reuptake inhibitors

(SSRIs) in the treatment of OCD.

AS GOOD AS IT GETS

Anxiety Disorders

Common Obsessions and Compulsions Among

People With Obsessive-Compulsive Disorder

Thought or Behavior Percentage*

Reporting Symptom

Obsessions (repetitive thoughts)

Concern with dirt, germs, or toxins 40

Something terrible happening (fire, death, illness) 40

Symmetry order, or exactness 24

Excessive hand washing, bathing, tooth brushing, 85

or grooming

Compulsions (repetitive behaviors)

Repeating rituals (in/out of a door, 51

up/down from a chair)

Checking doors, locks, appliances, 46

car brake, homework

Anxiety Disorders

• PET Scan of brain of person

with Obsessive/ Compulsive

disorder

• High metabolic activity (red) in

frontal lobe areas involved

with directing attention

Good examples of obsessions and their closely

related compulsions:

Obsession: A mother tormented by

concern that she might inadvertently

contaminate food as she cooks dinner.

Compulsion: Every day she sterilizes all

cooking utensils in boiling water and

wears rubber gloves when handling food

Obsession: A young

woman is continuously

terrified by the thought

that cars might careen

onto the sidewalk and

run over her.

Compulsion: She

always walks as far from

the street pavements as

possible and wears red

clothes so that she will

be immediately visible

to an out-of-control car.

Obsession: A woman cannot rid herself

of the thought that she might

accidentally leave her gas stove turned

on, causing her house to explode

Compulsion: Every day she feels the

irresistible urge to check the stove

exactly 10 times before leaving for work.

5) Post Traumatic Stress Disorder (PTSD) Follows a psychologically distressing event that is outside the

normal experience (rape, war, murder, beatings, torture, natural disasters)

*1 in 12 adults in the U.S.

suffer from PTSD

*incessant reliving of event,

recurring dreams, intrusive

memories, flashbacks,

intensive fears, sleep

problems.

*lasting biological effects:

causes the brain’s hormone-

regulating system to develop

hair-trigger responsiveness

Perpetration-induced traumatic stress (PITS)

*soldiers who had killed in combat were found to suffer higher rates of PTSD than other troops

*other studies include grief, survivor’s guilt, fear

p341 Zim

Holocaust Survivors Why do survivors of the Holocaust, a very traumatic experience, tended

to show no signs of PTSD?

*Differential Focus of Good= looking for good

in their lives

*Survival for some purpose = to tell the story

*Psychological distancing

*Mastery = helping others; create a sense of

worthiness and self-esteem

*Will to live = human determination to live

*Social Support = drew social support from

individual friendships or with others who

shared the same life situation

Example of this would be Boys of Buchenwald

Group of four hundred orphaned boys who has witnessed unimaginable horrors that were relocated to orphanages in France.

Elie Wiesel

5a) Stockholm Syndrome Follows a psychologically distressing event that is outside the normal

experience (rape, war, murder, beatings, torture, natural disasters)

*captor threatens to kill and is able to do so

*victim cannot escape or life depends on the

captor

*victim is isolated from outsiders

*captor is perceived as showing some degree

of kindness

*victim denies anger at abuser & focuses on

good qualities

*”fight or flight” reactions are inhibited

*victim fears interference by authorities--fears

the captor will return from jail

*victim is grateful to abuser for sparing her life

Example of this disorder would be Patty Hearst

Kidnapped by the Symbionese Liberation Army

a) Hypochondria

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

b) Conversion (hysteria)

Physical malfunction or loss of bodily control w/no underlying pathology but apparently related to psychological conflict.

6) Somotoform Disorders

Disorders, involving physical complaints for

which no organic basis can be found.

TREATMENTS:

*Medical model: antianxiety drugs (valium, librium,

xanax)

*Psychoanalysis: observational learning, childhood

(mom/dad), free association, resistance (transference)

*Learning Theories: classical conditioning,

counterconditioning, systematic desensitization

*Behaviorists: principles of learning, aversive

conditioning, operant conditioning (token economy)

*Cognitive Therapies: irrational interpretations

*Humanistic: client-centered therapies, responsibility,

active-listening.

THE WORLD OF AbNORMAL

BEHAVIOR:

#3 The Anxiety Disorders

DISORDERS

1) DEPRESSIVE DISORDERS

a) major depression

b) dysthymia

2) BIPOLAR DISORDER

a) mania

b) major depression

3) SEASONAL AFFECTIVE DISORDER (SAD)

Mood Disorders

1) Depressive Disorders *most common disorders” a mood disorder in which a person, for no apparent reason, experiences

two or more weeks of depressed moods, feelings of worthlessness, and diminished interest or pleasure in most activities

Mood Disorders

characterized by emotional extremes

a) Major Depressive Disorder

Unhappy for 2 weeks without reason, appetite changes, insomnia, inability to

concentrate, worthlessness, hallucinations

b) Dysthymia

Unhappy for over 2 years

Mood Disorders 2) Bipolar Disorder

*a mood disorder in which the person alternates between the hopelessness and lethargy of depression and the overexcited state

of mania

*formerly called manic-depressive disorder

a) Manic Episode

a mood disorder marked by a hyperactive, wildly optimistic state, excessive excitement, silliness, poor judgment, abrasive, rapid flight

of ideas

b) Major depression

Lethargic, sleepy, social withdrawal, irritability

Symptoms of Mania

1) Mood or emotional symptoms: euphoric, expansive, and elevated. In some

cases, dominant mood is irritability. Even when

euphoric, manic people are close to tears and if

frustrated, will burst out crying.

2) Grandiose cognition: manics believe no

limits to their abilities and do not recognize the

painful consequences of trying to carry out their

plans. May be delusional about themselves.

3) Motivational symptoms: hyperactivity has

intrusive, dominating, domineering quality. Some

engage in compulsive gambling, reckless driving,

or poor financial investment.

4) Physical symptoms: lessened need for

sleep. After a few days, exhaustion settles in.

•Between .6 and

1.1 percent of

U.S. population

will have bipolar

disorder in their

lifetime.

•It affects both

sexes equally.

•Onset is sudden.

•First episode

occurs between

ages 20 and 30.

Mood Disorders-Bipolar

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

Depressed state Manic state Depressed state

Mood Disorders-Depression

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

Age in Years

Famous People with Bipolar Disorder

Percentage

depressed Females

Canadian depression rates

3) Seasonal Affective Disorder (SAD)

Experience depression during certain times of the year

*usually winter (less sunlight)

*treated w/light therapy

*Alaska (dark for months)

Aaron Beck’s work with depressed patients convinced him

that depression is primarily a disorder of thinking rather than

of mood. He argued that depression can best be described

as a cognitive triad or negative thoughts about oneself, the

situation or the future.

Cognitive errors included the following:

1) overgeneralizing: drawing global conclusions about worth, ability, or

performance on basis of single fact

2) Selective abstraction: focusing on one insignificant detail and ignoring

others

3) Personalization: incorrectly taking responsibility for events in the world

4) Magnification & minimization: bad events magnified and good events

minimized.

5) Arbitrary inference: drawing conclusions without sufficient evidence

6) Dichotomous thinking: seeing everything in one extreme or its opposite.

Altering any one

component of

the chemistry-

cognition-mood

circuit can alter

the others

chemistry Cognition

Generally speaking, a deficit of serotonin is

associated with depression.

A happy or

depressed

strongly

influences

people’s

ratings of

their own

behavior Negative Positive

behaviors behaviors

Self-ratings

Percentage of

observations

The vicious

cycle of

depression

can be

broken at

any point

Stressful

experiences

Cognitive and

behavioral changes

Negative

explanatory style

Depressed

Boys who

were later

convicted

of a crime

showed

relatively

arousal

EXAMPLES of Mood Disorders:

Andrea Yates: postpartum

depression and the insanity

plea. It has been suggested

that at the far end of the

postpartum psychological

spectrum lie postpartum

psychosis. In Andrea’s

case, it represented a state

of mind in which killing one’s

children seemed the best

way to protect them.

Mood Disorders- Suicide

Mood Disorders-Suicide

Increasing rates of teen suicide

1960 1970 1980 1990 2000

Suicide rate,

ages 15 to 19

(per 100,000)

REASONS for suicide:

1) Unendurable psychological pain: if you reduce the pain just a little, most

suicidal people will choose to live.

2) Frustrated psychological needs: (security, achievement, trust, friendship)

3) Search for a solution: Suicide is never done without purpose --“How do I get

out of this?”

4) Attempt to end consciousness: goal is to stop awareness of painful

existence.

5) Helplessness & hopelessness: loss of power

6) Constriction of options: Not seeing the broad picture; limited options.

7) Ambivalence: Some is normal--In typical case, victim cuts throat and calls for

8) Communication of intent: 80 percent gives clear clues to family & friends

9) Departure: quitting job, running away from home, leaving spouse are all

departures but suicide is the ultimate departure.

10) Lifelong coping patterns: look for earlier episodes--often a style of problem

solving that is characterized as “cut and run.”

LONELINESS

Sharon Brehm reports that gender interacts with

marital status in the following ways:

•Married females report greater loneliness than

do married males

•Among those never married, males report more

loneliness than do females

•Among the separated and divorced, males report

greater loneliness than do females

•Among those whose spouse has died, males

report greater loneliness than do females.

REASONS for Loneliness

1) Being unattached

2) Alienation: being misunderstood & feeling different

3) Being alone: coming home to empty house

4) Forced isolation: hospitalized or housebound

5) Dislocation: starting new job or school

Four major strategies in coping with Loneliness:

1) Sad passivity: sleeping, drinking, overeating, watching TV

2) Social contact: calling friend

3) Active solitude: studying, reading, exercising, going to movie

4) Distractions: spending money, going shopping

TREATMENTS:

*Medical model: For bipolar-- lithium carbonate, carbamazepine,

and valproate. For depression--tricyclics; the newer selective serotonin re-uptake inhibitors (SSRIs), and monoamine oxidase inhibitors (MAO inhibitors). Electroconvulsive therapy (ECT) uses small amounts of electricity applied to the scalp to affect neurotransmitters in the brain.

*Psychoanalysis:

*Learning Theories:

*Behaviorists:

*Cognitive Therapies: interpersonal therapy

*Humanistic: client-centered therapies, responsibility, active-listening,

emotional support and assistance in recognizing signs of relapse to avert a full-blown episode

THE MIND

#31 Mood Disorders: Mania & Depression

#32 Mood Disorders: Hereditary Factors

#33 Mood Disorders: Medication and Talk

Therapy

THE WORLD OF AbNORMAL PSYCHOLOGY:

#8 Mood Disorders

DISSOCIATIVE

DISORDERS

1) PSYCHOGENIC AMNESIA

2) PSYCHOGENIC FUGUE

3) DISSOCIATIVE IDENTITY DISORDER

(Multiple Personality Disorder)

4) DEPERSONALIZATION DISORDER

Dissociative Disorders

– conscious awareness becomes separated

(dissociated) from previous memories,

thoughts, and feelings

Dissociative Disorders

1) Psychogenic Amnesia

– Sudden inability to recall important

information--NOT as a result of physical

“blow” or drug-related.

2) Psychogenic Fugue

– Loss of memory--flees to a new location and

establishes new lifestyle

– After recovery, events during fugue are not

remembered

Dissociative Disorders 3) Dissociative Identity Disorder

– rare dissociative disorder in which a person

exhibits two or more distinct and alternating

personalities

– formerly called multiple personality disorder

*often history of child or sex abuse

In 2008, Herschal Walker, the 1982 Heisman

Trophy winner from the University of Georgia,

released his book “Breaking Free” which related

his experiences with DID. He reported not

being able to remember winning the

Heisman in 1982 or darker events, such as threatening his then-wife.

4) Depersonalization Disorder

– Persistent, recurring feelings that one is not

real or is detached from one’s own

experience or body.

depression,

mood swings,

suicidal tendencies,

sleep disorders (insomnia, night

terrors, and sleep walking),

panic attacks and phobias

(flashbacks, reactions to stimuli

or "triggers"),

alcohol and drug abuse,

compulsions and rituals,

psychotic-like symptoms

(including auditory and visual

hallucinations),

eating disorders

headaches,

amnesias,

time loss,

trances, and "out of body

experiences."

self-persecution,

self-sabotage

violence (both self-inflicted and

outwardly directed).

People with Dissociative Disorders may experience any of the

following:

Dissociative Disorders are now understood

to be fairly common effects of severe

trauma in early childhood, most typically

extreme, repeated physical, sexual, and/or

emotional abuse. Posttraumatic Stress

Disorder (PTSD), widely

accepted as a major mental

illness affecting 8% of the

general population in the

United States, is closely

related to Dissociative

Disorders. In fact, 80-100%

of people diagnosed with a

Dissociative Disorder also

have a secondary diagnosis

of PTSD

Recent

research

suggests the

risk of suicide

attempts

among people

with trauma

disorders may

be even higher

than among

people who

have major

depression.

There is

evidence that

people with

trauma disorders

have higher rates

of alcoholism,

chronic medical

illnesses, and

abusiveness in

succeeding

generations.

TREATMENTS:

*Medical model: therapy to recall the memories, hypnosis

or a medication called Pentothal (thiopental) can

sometimes help to restore the memories

*Psychoanalysis: help an individual deal with the trauma

associated with the recalled memories. Fugue--Hypnosis.

Dissociative identity disorder-- long-term psychotherapy

that helps the person merge his/her multiple personalities

into one.

*Learning Theories:

*Behaviorists:

active-listening.

Sybil Part I

Sybil Part II

PERSONALITY

DISORDERS

1) Paranoid Personality Disorder (PPD)

2) Obsessive-Compulsive Personality Disorder(OCPD)

3) Antisocial Personality Disorder

4) Borderline Personality Disorder

5) Schizoid Personality Disorder

6) Schizotypal Personality Disorder

7) Narcissistic Personality Disorder

Personality Disorders

*disorders characterized by inflexible and

enduring behavior patterns that impair

social functioning

*usually without anxiety, depression, or

delusions

Personality Disorder Types

1) Paranoid Personality Disorder Suspicious, envious, extreme jealousy,

tendency to interpret actions of others as

demeaning or threatening.

2) Obsessive-Compulsive Personality Disorder

*Obsession: Recurring thoughts or images that seems irrational & out of control (locking doors, worry, dying)

*Compulsion: irresistible urge to act or engage in ritualistic behavior

***interferes with daily life

Treatment: A physician in this instance is best sticking with the

facts of the presenting problem and underlying disorder rather than offering vague impressions of their opinion. Since the individual with this disorder tends to be meticulous and concerned with details, the treatment regimen -- once accepted -- will likely be adhered to rigorously, without incident.

Example: Howard

Hughes

Personality Disorder Types 3) Antisocial Personality Disorder

*disorder in which the person exhibits a lack of conscience for wrongdoing, even toward friends and family members

*may be aggressive and ruthless or a clever con artist, no regard for truth, irresponsible behavior, failure to conform to social norms

*Intelligent, charming

*social skills

*75% men

*Potentially dangerous

Example:

Hannibal Lecter in

Silence of the

Treatment--Because many people who suffer from this disorder will be mandated to therapy in a forensic or jail setting, motivation on the patient's part may be difficult to find. Therapy should focus on alternative life issues, such as goals for when they are released from custody, improvement in social or family relationships, learning new coping skills, etc. In an outpatient setting, the focus of therapy can also be on these types of issues, but a part of the therapy should be devoted to discussing the antisocial behavior and feelings (or lack thereof).

4) Borderline Personality Disorder *Unpredictable, impulsive, angry outbursts

*Experiences guilt, remorse, & appropriate emotions

*75% female Treatment: Dialectical Behavior Therapy: teaches the client how to learn to better take control of their lives, their emotions, and themselves through self-knowledge, emotion regulation, and cognitive restructuring.

**Although carriers of this personality disorder are

frequently found among street criminals and con artists,

they are also well represented among successful

politicians and business people who put career, money,

and power above everything and everyone.

**Two to three percent of the population in the U.S.

may have antisocial personality disorder.

**Chronic lying, stealing, and fighting are common signs.

**Violations of social norms begin early in life--

disrupting class, getting into fights, and running

away from home.

5) Schizoid Personality Disorder *Lack of interest in social relations

*Inability to express feelings

6) Schizotypal Personality Disorder *Egocentricity, avoidance of others, eccentricity of

thought

*Oversensitive & frequently see chance events as related to themselves.

*Individuals with this disorder usually distort reality more so than someone with Schizoid Personality Disorder.

7) Narcissistic Personality Disorder *Preoccupied with receiving attention & nurturance

*Exaggerated sense of self-importance

Treatment: Hospitalization of patients with severe Narcissistic Personality occurs frequently, such as those who are quite impulsive or self-destructive, or who have poor reality-testing.

• PET scans illustrate reduced activation in

a murderer’s frontal cortex

Normal Murderer

Percentage

of criminal

offenders

Total crime Thievery Violence

Childhood

poverty

Obstetrical

complications

Both poverty

and obstetrical

complications

Rates of Psychological Disorders Percentage of Americans Who Have Ever Experienced Psychological Disorders

Disorder White Black Hispanic Men Women Totals

Ethnicity Gender

Alcohol abuse

or dependence 13.6% 13.8% 16.7% 23.8% 4.6% 13.8%

Generalized anxiety 3.4 6.1 3.7 2.4 5.0 3.8

Phobia 9.7 23.4 12.2 10.4 17.7 14.3

Obsessive-compulsive

disorder 2.6 2.3 1.8 2.0 3.0 2.6

Mood disorder 8.0 6.3 7.8 5.2 10.2 7.8

Schizophrenic

disorder 1.4 2.1 0.8 1.2 1.7 1.5

Antisocial personality

disorder 2.6 2.3 3.4 4.5 0.8 2.6

TREATMENTS:

*Medical model:

*Psychoanalysis: SchizoidPD--individual therapy (brief), SchizotypalPD-

-the clinician must exercise care to not directly challenge delusional or

inappropriate thoughts…warm, supportive, and client-centered environment should be established with initial rapport.

*Learning Theories:

*Behaviorists:

*Cognitive Therapies: BorderlinePD--Dialectical Behavior

Therapy: teaches the client how to learn to better take control of their

lives, their emotions, and themselves through self-knowledge, emotion regulation, and cognitive restructuring.

*Humanistic: Group setting (BPD), client-centered therapies (OCPD),

responsibility, active-listening, NarcissisticPD--Small staff-patient groups--feelings are shared and patients' comments taken seriously by staff, constructive work assignments, recreational activities, and opportunities to sublimate painfully conflictual impulses.

THE MIND

#35 The Mind of The Psychopath

PSYCHOLOGY:

#5 Personality Disorders

Gacy or Bundy

SCHIZOPHRENIC

DISORDERS (also called Psychotic Disorders)

Schizophrenia literally means “split mind,” meaning a split from

reality that shows itself in disorganized thinking, disturbed

perceptions and inappropriate emotions and actions.

PSYCHOTIC: split from reality

The term coined by

Emil Kraepelin, who

established the

diagnostic category

“dementia praecox” and

Eugen Bleuler, who

introduced the term

“schizophrenia.” 1874, Medicene,

Leipzig & Wurtzburg,

Germany

(1857-1939)

Medicene, University

of Bern

Possible symptoms of psychotic illnesses include:

*Disorganized or incoherent speech

*Confused thinking

*Strange, possibly dangerous behavior

*Slowed or unusual movements

*Loss of interest in personal hygiene

*Loss of interest in activities

*Problems at school or work and with relationships

*Cold, detached manner with the inability to express

emotion

*Mood swings or other mood symptoms, such as

depression or mania

CAUSES:

•chemical imbalances (“mad as a hatter”)

•excess D4 dopamine receptors (in autopsies) (drugs that

block dopamine receptors lessen the symptoms)

•now researching neurotransmitter glutamate (direct neurons

to pass along an impulse)

•abnormal brain activity: low in frontal lobes

•research shows (during hallucinations) increased activity in

thalamus, amygdala, and cortex

•greater than normal cerebral cortex tissue loss between

ages 13 and 18.

•genetics: enlarged, fluid-filled cranial cavities

Identical Twin studies show:

*48% probability of having schizophrenia if your twin

*single placenta: 6 in 10 chance

*separate placentas: 1 in 10 chance

*one study showed the older the father, the greater risk

of schizophrenia in offspring

The GENAIN QUADRUPLETS (b.1930) were monozygous

women all suffered from schizophrenia, demonstrating a

large genetic component to the disease. The girls (Nora,

Iris, Myra, Hester) were fictitiously named for NIMH

(National Institute of Mental Health). Both parents had

mental disorders during their lifetime.

A common finding in

the brains of people

with schizophrenia is

larger than normal

lateral ventricles.

significant vertical

displacement of the

lateral ventricles in

corresponds to the

displacement of the

corpus callosum.

DIANTHESIS-STRESS HYPOTHESIS:

The idea that biological factors may place

the individual at risk for schizophrenia (or

others), but environmental stressors

transform this potential into an actual

disorder.

1) DISORGANIZED

2) CATATONIC

3) PARANOID

4) UNDIFFERENTIATED

5) RESIDUAL

*6) PARANOID DELUSIONAL DISORDER

1) DISORGANIZED SCHIZOPHRENIC

• confused and incoherent,

• jumbled speech

• emotionless or flat or inappropriate, even silly or childlike.

(flat affect or lack of affect)

• disorganized behavior that may disrupt their ability to

perform normal daily activities (showering or preparing

meals)

• hallucinations and delusions

Disorganized speech is of two types:

NEOLOGISMS: “new words”

WORD SALAD: “disorganization”

“I had belly bad luck and brutal and outrageous.” (I have

stomach problems and don’t feel good) “I gave all the work

money. (I paid tokens for my meal) I was raised in packs (with

other people) and since I was in littlehood (little girl) she

blamed a few people with minor words (she scolded people).

The lion will have to change from dogs into cats until I can meet my

father and mother and we depart some rats. I live on the front part of

Whitton’s head. You have to work hard if you don’t get into bed. She

did. She said, “Hallelujah, happy landings.” It’s all over for a squab

true tray and there ain’t not squabs, there ain’t no men, there ain’t no

music, there ain’t no nothing besides my mother and my father who

stand alone upon the Island of Capri where there is no ice, there ain’t

no nothing but changers, changers, changers…….

2) CATATONIC SCHIZOPHRENIC

•Physical symptoms

• immobile and unresponsive to the world around them

• very rigid and stiff, unwilling to move

• waxy flexibility

• occasional grimacing or bizarre postures.

• might repeat a word or phrase just spoken by another person.

• increased risk of malnutrition, exhaustion, or self-inflicted injury.

Catatonic excitement: patients become agitated and

hyperactive.

3) PARANOID SCHIZOPHRENIC

• preoccupied with false beliefs (delusions) about being

persecuted or being punished by someone

• thinking, speech and emotions, however, remain fairly

normal.

•the paranoid delusions of persecution or grandiosity

(highly-exaggerated self-importance) are less well

organized--more illogical--than those of the patient with

purely delusional disorder.

•delusions are usually auditory

4) UNDIFFERENTIATED SCHIZOPHRENIC

* diagnosed when the person's symptoms do not clearly

represent one of the other three subtypes.

5) RESIDUAL SCHIZOPHRENIC

* suffered from schizophrenia in the past but no

hallucinations or delusions

• mildly disturbed thinking

• emotionally impoverished

**6) PARANOID DELUSIONAL DISORDER

• characterized by non-bizarre delusions in the absence of

other mood or psychotic symptoms

•delusions involving real-life situations that could be true,

such as being followed, being conspired against or having

a disease

• delusions persist for at least one month.

• non-bizarre refers to situations such as: being followed,

being loved, having an infection, or being deceived by

one’s spouse

• needs to be evaluated with respect to religious and

cultural differences.

TREATMENTS:

*Medical model: Start: olanzapine (Zyprexa), quetiapine

(Seroquel), risperidone (Risperdal), or aripiprazole (Abilify)….Then: chlorpromazine, fluphenazine, and haloperidol…. Last resort: Clozapine (Clozaril) (has side effects)

*Psychoanalysis: medication, psychological counseling

and social support.

*Learning Theories:

*Behaviorists: medication, psychological counseling and

social support.

*Cognitive Therapies:

*Humanistic: medication, psychological counseling and

social support.

ABC Schizophrenia

THE WORLD OF ABNORMAL

PSYCHOLOGY

#9 The Schizophrenias

Mindstorm

BIOPSYCHOSOCIAL

DISORDERS

1) CORONARY HEART DISEASE

2) MIGRAINE HEADACHES

3) BREAST CANCER

4) ANOREXIA NERVOSA

5) BULIMIA NERVOSA

Biopsychosocial Disorders

1) Coronary Heart Disease (Ch 14, p. 539-

*Lethal blockage of arteries that supply blood to

heart muscle

*Causes: age, gender, family history, blood

pressure, chloresterol, weight, lifestyle,

psychological state (type A personality)

2) Migraine Headaches (not in book)

*Intensely painful, recurring headache--reduced flow of bloodto certain parts of brain--overarousal of sympathetic nervous system

*Causes: stress, change in weather, hormonal changes

*Family history

***Seeing zigzag lines or flashing lights, tingling, numbness in arms & legs.

3) Breast Cancer (Ch 14, p.543-544)

*Over 50, no children, family history

*Stressful life leads to higher level of the disease

Swedish researchers say that being under

stress may double a woman's risk of

developing breast cancer.They based their

findings on surveys of more than 1,400

Swedish women in the late 1960s who

were part of a long-term health-care study.

They found that women who reported

being under stress had twice the risk of

developing breast cancer as women who

managed to stay cool, calm, and collected.

4) Anorexia Nervosa (Ch 12, p.454-467)

*Eating disorder, intense abhorrence of obesity, insistance that one is fat

*Loss of 25%+ original body fat

*Refusal to maintain normal weight

5) Bulimia Nervosa (Ch 12, p. 464-467)

*Unable to stop eating voluntarily

*Preoccupation with weight gain

*Attempt to lose weight thru binge eating, self-induced vomiting & overuse of laxatives and diuretics

QuickTime™ and aTIFF (Uncompres sed) decompres sor

are needed to see this p icture .

A surplus of serotonin is associated

with anorexia

1) INJURY

2) ALZHEIMERS DISEASE

3) KORSAKOFF’S SYNDROME

4) PARKINSON’S DISEASE

Neurophysical Disorders

1) Injury (not in book)

*Brain trauma

2) Alzheimers (Ch 4, p 177-178)

**trouble remembering recent events, activities, or the names of familiar people or things

**Age (number of people w/disease doubles every 5 years past age 65 )

**family history (usually occurs between age 30-60 if it’s genetic). . . . One risk factor for this type of AD is a protein called apolipoprotein E (apoE).

3) Wernicke’s-Korsakoff’s Syndrome (not in book)

*memory disorder caused by a lack of vitamin B1 (thiamine).

*affects short-term memory.

*Most common cause: alcoholism

*A related disorder, Wernicke's syndrome, often occurs before Korsakoff's syndrome. Because they often occur together, the range of symptoms caused by the two diseases is often called Wernicke's-Korsakoff syndrome. The main symptoms of Wernicke's syndrome occur acutely. They include:

• Difficulty with walking and balance

• Confusion

• Drowsiness

• Paralysis of some eye muscles

3) Korsakoff’s Syndrome

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

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

4) Parkinson’s Syndrome (not in book)

*tremor in hand, foot, mouth, or chin

*stiffness or rigidity of the limbs and trunk

*bradykinesia (slowness of movement)

*postural instability, or impaired balance and coordination

*Occurs in about 1% of people over 65, 15% in ages 74-85, and

over 50% of people over 85

• Parkinson’s Disease (not in book)

caused by the progressive impairment or

deterioration of neurons (nerve cells) in

an area of the brain known as the

substantia nigra. When functioning

normally, these neurons produce a vital

brain chemical known as dopamine.

Dopamine serves as a chemical

messenger allowing communication

between the substantia nigra and

another area of the brain called the

corpus striatum. This communication

coordinates smooth and balanced

muscle movement. A lack of dopamine

results in abnormal nerve functioning,

causing a loss in the ability to control

body movements.

• Parkinson’s Disease – Why Parkinson’s

occurs and how the neurons become impaired is not known. However, increasing evidence suggests that it may be inherited.

TREATMENTS:

*Medical model:

*Psychoanalysis:

*Learning Theories:

*Behaviorists:

active-listening.

PSYCHOLOGY

#10 Organic Brain Disorders

SUBSTANCE ABUSE

DISORDERS

1) ALCOHOL

2) COCAINE

3) METHALAMPHETAMINES

4) NICOTINE

Substance Abuse Disorders

1) Alcohol (Ch 7, p.294-304)

*Drinking impairs life adjustments

*Health, personal relationships, occupational functioning

*Strong relationship between alcohol & violence.

Am I drinking too much?

YES, if you are:

･A woman who has more than seven drinks* per week or more than

three drinks per occasion

･A man who has more than 14 drinks* per week or more than four

drinks per occasion

･Older than 65 years and having more than seven drinks* per week

or more than three drinks per occasion *--One drink = one 12-oz bottle of beer (4.5 percent alcohol) or one 5-oz glass of wine (12.9 percent alcohol) or 1.5 oz of 80-

proof distilled spirits.

2) Cocaine (Ch 7, p.294-304)

*Chronic abuse can promote acute psychotic symptoms & hallucinations

*Activates the part of the brain as areas of pleasure & rewards (food, sex, water)

*Long term effects include:

Addiction

Irritability and mood disturbances

Restlessness

Paranoia

Auditory hallucinations

3) Methamphetamines

*synthetic amphetamines or stimulants that are produced and sold illegally in pill form, capsules, powder and chunks.

*has a structure similar to dopamine (the brain's pleasure transmitter) and causes neurons to release large amounts of dopamine to produce a high. ……… leads to permanent brain damage as natural dopamine production sites are destroyed - forcing the user to become even more reliant on meth for pleasure.

*known as meth, crank, glass, speed, crystal, ice, batu, chalk, shabu, or zip QuickTime™ and a

TIFF (Uncompressed) decompressorare needed to see this pic ture.

4) Nicotine (Ch 7, p.294-304)

*Poisonous substance in cigarettes

*450,000 related deaths per year.

**Used as a coping device

TREATMENTS:

*Medical model:

*Psychoanalysis:

*Learning Theories:

*Behaviorists:

active-listening.

PSYCHOLOGY:

#6 Substance Abuse Disorders

The Meth Epidemic

Psych in Film, Ver 2, #25, Lost

Weekend (alcoholism)

SEXUAL

DISORDERS

1) GENDER IDENTITY DISORDER (TRANSSEXUALISM)

2) SEXUAL DISFUNCTION

3) PARAPHILIAS

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

1) Gender Identity Disorder (Transsexualism)

*Confusion or uncertainty between biological sex and gender identity.

2) Sexual Disfunction

*Inhibitions in sexual response

Sexual Disorders

3) Paraphilias

– Fetishism, zoophilia, pedophila, exhibitionism, voyeurism, masochism, sadism et. al.

– Sexual response to unusual objects or situations

TREATMENTS:

*Medical model:

*Psychoanalysis:

*Learning Theories: classical conditioning.

*Behaviorists:

active-listening.

PSYCHOLOGY:

#7 Sexual Disorders

DEVELOPMENTAL

(CHILDHOOD)

DISORDERS

1) ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD)

2) CONDUCT DISORDER

3) SEPARATION ANXIETY DISORDER

4) AUTISM

5) DYSLEXIA

1) Attention Deficit Hyperactivity Disorder (ADHD) (not

in book)

*Maladaptive behavior that interferes with effective task-oriented

behavior

*Impulsively, excessive motor activity, exaggerated muscular

activity, difficulty maintaining attention

*controversial diagnosis

*Critics claim ADHD is overdiagnosed (i.e.)blame

children for unskilled parents or teachers.

*drug treatment includes stimulants

*stimulant drug therapy combined with behavioral

therapy can improve attention and diminished

hyperactivity in 70% of ADHD children.

*Strattera -- a drug used for ADHD is a norepinephrine

retake inhibitor

2) Conduct Disorders (not in book)

*Persistant, repetitive violation of rules and disregard for rights of others

*Fighting, defiance, disobedience, destruction of property, attention seeking, inattentiveness, over-aggressive behavior, bullying, physical aggression, cruel behavior toward people and pets, destructive behavior, lying, truancy, vandalism, and stealing.

*ODD--Oppositional Defiant Disorder: disobedient, hostile behavior towards authority figures

*clinically significant impairment in social, academic, or occupational functioning.

3) Separation Anxiety Disorder (not in book)

*Excessive anxiety about separation from people to whom the child is attached

*Unrealistic fears, oversensitivity, self-consciousness, nightmares, chronic anxiety

4) Autism (p. 147-148, 424, 668)

*Pervasive developmental disorder occurring in infancy or childhood

*Qualitative impairment in reciprocal social interaction & communication--restricted repertoire of activities & interests

Example: Sally and Ann are playing together, when Sally puts a piece of candy

in a box and leaves the room. While Sally is gone, Anne opens the box,

removes the candy and stashes it in her purse. When Sally comes back, where

will she look for the candy?

Normal children will say that Sally will look in the box. Autistic

children are most likely to say (if they communicate at all) that

Sally will look in the purse. The autistic child lacks “theory of

mind”. Severely autistic children cannot imagine themselves

in Sally’s place.

5) Dyslexia

*reading difficulties

*affects 1 of 5 children

*involves the abnormalities in the brain’s language-processing circuits.

Another cause may be language itself:

*English: bizarre spelling menagerie, containing 1120 ways

to spell only 40 different sounds, are more likely to be

dyslexic than

*Italian: 33 combinations of letters for 25 sounds.

TREATMENTS:

*Medical model: Stimulants (ADHD)

*Psychoanalysis:

*Learning Theories: Token Economy

*Behaviorists:

active-listening.

PSYCHOLOGY:

#11 Behavior Disorders of Childhood

Psych in Film, Ver 2, #26, Mercury

Rising (autism), #20, Sixteen Candles,

#21, Snow Falling on Cedars (cross-

cultural), #15, Parenthood (special

needs child)

ADJUSTMENT

DISORDERS

ADJUSTMENT DISORDERS:

Other conditions that may be a focus of

clinical attention.

*mild depression

*physical complaints

*marital problems

*academic problems

*job problems

*parent-child problems

*bereavement

*malingering (faking an illness)

TREATMENTS:

*Medical model:

*Psychoanalysis:

*Learning Theories:

*Behaviorists:

active-listening.

TREATMENTS:

*Medical model:

*Psychoanalysis:

*Learning Theories:

*Behaviorists:

active-listening.

Psych in Film, ver 2, #28, American Werewolf

in London (sleep disorders)

Questions for

Review

1) RECALL In Rosenhan’s study, who discovered that the

“pseudopatients” were feigning mental illness?

a) psychiatrists

b) psychologists

c) Nurses and aides working on the ward

d) Other patients

e) Other physicians

2) APPLICATION Which of the following symptoms most clearly suggests

the presence of abnormality?

a) hallucinations

b) worries

c) Unusual behavior

d) creativity

e) distraction

3) RECALL Hippocrates proposed that mental disorder was caused

a) Possession by demons

b) An imbalance in four bodily fluids

c) A fungus growing on rye grain

d) Traumatic memories in the unconscious

e) The taking of potions.

4) RECALL The behavioral perspective emphasizes the influence of

__, while the cognitive perspective emphasizes __.

a) Genetics / conscious processes

b) Conscious processes / unconscious processes

c) Heredity / environment

d) Medical factors / psychological factors

e) The environment / mental process

5) UNDERSTANDING THE CORE CONCEPT Which of the following would be least likely to be

noticed by a clinician using strictly the medical

model of mental disorder?

a) delusions

b) Severe disturbances in affect

c) An unhealthy family environment

d) A degenerative brain disease

e) hallucinations

6) RECALL The DSM IV is based on the

a) Cognitive perspective

b) Behavioral perspective

c) Eclectic view

d) Psychoanalytic view

e) medical model

7) RECALL Which disorder involves extreme swings of mood from

elation to depression?

a) Panic disorder

b) Bipolar disorder

c) schizophrenia

d) Unipolar depression

e) PTSD

8) APPLICATION According to the preparedness hypothesis, which one of

the following phobias would you expect to be most

common?

a) Fear of snakes (ophidiophobia)

b) Fear of books (bibliophobia)

c) Fear of horses (equinophobia)

d) Fear of the number 13 (triskaidekaphobia)

e) Fear of water (aquaphobia)

9) RECALL Which of the following disorders involves a deficiency in

memory?

a) phobia

b) Antisocial personality

c) Dissociative fugue

d) obsessive-compulsive diorder

e) schizophrenia

10) RECALL Which of the following is a disorder in which the

individual displays more than one distinct

personality?

a) schizophrenia

b) Depersonalization disorder

c) Bipolar disorder

d) phobia

e) Dissociative identity disorder

11) RECALL Which of the following is primarily a disorder of young

American women?

a) Bipolar disorder

b) schizophrenia

c) Anorexia nervosa

d) Antisocial personality disorder

e) Dissociative identity disorder

12) RECALL Hallucinations and delusions are symptoms of

a) schizophrenia

b) Somatoform disorders

c) Anxiety disorders

d) Depersonalization disorders

e) Panic disorders

13) RECALL Which category of disorder is most common?

a) schizophrenia

b) Dissociative disorder

c) Eating disorders

d) The adjustment disorders and “other conditions that

may be a focus of clinical attention”

e) Mood disorders

14) UNDERSTANDING THE CORE CONCEPT The DSM-IV groups most mental disorders by their

a) treatments

b) causes

c) symptoms

d) theoretical basis

e) cures

15) UNDERSTANDING THE CORE CONCEPT Which unfortunate consequence of diagnosing mental

disorders is emphasized chapter?

a) The inaccuracy of diagnosis

b) Stigmatizing those with mental disorders

c) Adding to the already overcrowded conditions in

mental hospitals

d) That some cultures do not recognize mental

disorders

e) The importance of the insanity defense.

16) RECALL Which one of the following statements is true?

a) Mental disorders have a similar prevalence in all cultures

b) In general, biology creates mental disorder, while culture

merely shapes the way a person experiences it.

c) Culture-specific stressors occur primarily in developing

countries

d) Cultures around the world seem to distinguish between

people with mental disorders and people who are

visionaries or prophets.

e) Mental disorders are more prevalent in Eastern culture.

17) RECALL Insanity is

a) Psychological term

b) Psychiatric term, found in DSM-IV under

“psychotic disorders.”

c) Legal term

d) Term that refers either to “neurotic” or “psychotic”

symptoms

e) A classification for those seeking treatment.

18) RECALL A long-standing pattern of irresponsible behavior that

hurts others without causing feelings of guilt or

remorse is typical of

a) An obsessive-compulsive disorder

b) An antisocial personality disorder

c) A narcissistic personality disorder

d) Paranoid schizophrenia

e) Dissociative fugue.

19) APPLICATION A young woman wanders into a hospital, claiming not to

know who she is, where she is from, or how she got

there. Her symptoms indicate that she might be

suffering from a(n) ____ disorder

a) anxiety

b) affective

c) personality

d) dissociative

e) mood

20) RECALL ____ has been called the “common cold of

psychopathology” because it occurs so frequently and

because almost everyone has experienced it, at least

briefly, at some time.

a) Obsessive-compulsive disorder

b) Bipolar disorder

c) Depression

d) Paranoid schizophrenia

e) Autism

21) RECALL A person who suffers from ____ cannot eat normally but

engages in a ritual of “binging”--periodic binges of

overeating--followed by “purging” with induced

vomiting or use of laxitives.

a) Anorexia nervosa

b) Bulimia nervosa

c) Inhibition

d) Mania

e) Depression

22) RECALL The ____ type of schizophrenia is characterized by

delusions.

a) residual

b) catatonic

c) paranoid

d) undifferentiated

e) disorganized

23) RECALL Rosenhan believes that his “pseudopatients” were not

recognized as normal because

a) The staff members in the mental hospital were

incompetent

b) The staff members in the mental hospitals were just

as disturbed as the patients

c) Mental illness is a myth

d) Staff members did not expect patients to be normal

e) He denied the existance of psychological disorders

24) MATCHING

a) Hallucinations f) Somatoform disorders

b) Delusions g) Dissociative disorders

c) Medical model h) Diathesis-stress hypothesis

d) Mood disorders i) Borderline personality disorder

e) Anxiety disorders j) Autism

____Extreme disorders of thinking, involving

persistent false beliefs.

25) MATCHING

_____A developmental disorder marked by

disabilities in language and social interaction.

26) MATCHING

_____ A class of disorders including bipolar

disorder.

28) MATCHING

_____ A class of disorders including panic

disorder.

29) MATCHING

_____ A disorder characterized by an unstable

personality given to impulsive behavior for which

includes remorse after the fact.

30) MATCHING

_____ A class of disorders including

depersonalization disorder.

31) MATCHING

_____ A class of disorders including conversion

disorder.

32) MATCHING

_____ False sensory experiences that may

suggest a mental disorder.

33) MATCHING

_____ The view that mental disorders are

diseases that have objective physical causes and

require specific treatments.

34) MATCHING

_____ The proposal that genetic factors place the

individual at risk while environmental stress factors

transform this potential into schizophrenic disorder.

#21, Zimbardo, Psychopathology

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