psychology ch. 14: psychological disorders
1. antisocial personality disorder
antisocial personality disorder: the pervasive pattern of disregard for, and violation of, the rights of others, beginning in childhood or early adolescence and continuing into adulthood - includes traits like unlawful behaviors, deceitful and manipulative behaviors, impulsivity, irritability and aggressiveness, consistent irresponsibility, reckless disregard for self and others, and lack of remorse. - also sometimes referred to as psychopathy, sociopathy, or dissocial personality disorder labels describe behavior so far outside the ethical and legal standards of society that many consider it the most serious of all mental disorders - sufferers feel little personal distress (and may not be motivated to change). - BUT their maladaptive traits generally bring considerable harm and suffering to others - serial killers are often seen as classic examples of people with antisocial personality disorder, but most people who have this disorder generally harm others in less dramatic ways - individuals with antisocial personality disorder act impulsively, without giving thought to the consequences. - usually poised when confronted with their destructive behavior and feel contempt (feeling that a person or a thing is beneath consideration) for anyone they are able to manipulate. - change jobs and relationships suddenly, and they often have a history of truancy from school and of being expelled for destructive behavior. - can be charming and persuasive, and they have remarkably good insight into the needs and weaknesses of other people. biological: twin and adoption studies suggest a possible genetic predisposition to antisocial personality disorder - biological contributions are also suggested by studies that have found abnormally low autonomic activity during stress, right hemisphere abnormalities, and reduced gray matter in the frontal lobes and biochemical disturbances (ex: mri brain cans of criminals currently in prison for violent crimes, such as rape, murder, or attempted murder, and showing little empathy and remorse for their crimes, revealed reduced gray matter volume in the prefrontal cortex) environmental/psychological causes - sufferers often come from homes characterized by abusive parenting styles, emotional deprivation, harsh and inconsistent disciplinary practices, and antisocial parental behavior *strong interaction between both heredity and environmental factors
*gender differences
around the world, the rate of severe depression for women is about double that for men - poverty is a well-known contributor to many psychological disorders, and women are far more likely than men to fall into the lowest socioeconomic groups. - women also experience more sexual trauma, partner abuse, and chronic stress in their daily lives some gender differences in depression may relate to the way women and men tend to internalize or externalize their emotions. - women ruminate more frequently than men = they are more likely to focus repetitively on their internal negative emotions and problems rather than engage in more external problem-solving strategies. - men tend to be more disinhibited and more likely to externalize their emotions and problems gender differences may result from misapplied gender role stereotypes - ex: the most common symptoms of depression, such as crying, low energy, dejected facial expressions, and withdrawal from social activities, are more socially acceptable for women than for men gender differences in depression are more pronounced in cultures with traditional gender roles suggests that male depression may be under-diagnosed because men are raised to be better at hiding and redirecting their emotions - U.S. society: men are typically socialized to suppress their emotions and to show their distress by acting out (showing aggression), acting impulsively (driving recklessly and committing petty crimes), or engaging in substance abuse.
*explaining schizophrenia
because schizophrenia comes in many different forms, it probably has multiple biological and psychosocial bases.
*explaining depressive and bipolar disorders
biological and psychosocial factors that contribute to disorders of mood
3. emotion
changes in emotion usually occur - emotions can be exaggerated and fluctuate rapidly, other times, they become blunted. - some people have flattened effect which is almost no emotional response of any kind
2. psychosocial factors
diathesis-stress model: a hypothesis about the cause of certain disorders, such as schizophrenia, which suggests that people inherits a predisposition (or diathesis: a tendency to suffer from a particular medical condition) that increases their risk of mental disorders if they are exposed to certain extremely stressful life experiences. - stress plays an essential role in triggering schizophrenic episodes in people with an inherited predisposition towards the disease (ex: children who experience severe trauma before age 16 are three times more likely than other people to develop schizophrenia / people who experience stressful living environments, including poverty, unemployment, and crowding, are also at increased risk) communication disorders in family members may also be a predisposing factor - such disorders include unintelligible speech, fragmented communication, and parents frequently sending severely contradictory messages to children. - studies have also shown greater rates of relapse and worsening of symptoms among hospitalized patients who went home to families that were critical and hostile toward them or overly involved in their lives emotionally *these theories fit only some cases of schizophrenia - with both theories, it is difficult to determine cause and effect. - the disturbed-communication theories are also hotly debated, and research is inconclusive. - schizophrenia is probably the result of a combination of known and unknown interacting factors
*dissociative disorders
dissociative disorder: psychological disorder marked by a disturbance in the integration of consciousness, identity, memory, and other features. - most dramatic psychological disorders are dissociative disorders - psychological dysfunctions characterized by a major loss of memory without a clear physical cause - several types, but all are characterized by a splitting apart (a dis-association) of significant aspects of experience from memory or consciousness - primarily caused by environmental variables, with little or no genetic influence dissociative identity disorder (DID): a mental disorder characterized by the presence of two or more distinct personality systems in the same individual at different times; previously known as multiple personality disorder (MPD). - most severe dissociative disorder - diagnosed about equally among men and women - each personality has unique memories, behaviors, and social relationships. - transition from one personality to another occurs suddenly and is often triggered by psychological stress. - the original personality has no knowledge or awareness of the alternate personalities, but all the personalities may be aware of lost periods of time. DID is a controversial diagnosis - many cases are faked or result from false memories and an unconscious need to please the therapist - on the other side of the debate are psychologists who accept the validity of DID and provide treatment guidelines
4. behavior
disturbances in behavior may take the form of unusual actions that have special meaning to the sufferer - example: one person massaged his head repeatedly to "clear it" of unwanted thoughts. - sufferers also may become cataleptic (loss of sensation and consciousness accompanied by rigidity of the body) and assume a nearly in-mobile stance for an extended period
*anxiety disorders*
experiences and symptoms of those who suffer from anxiety disorders are much more intense and life disturbing - anxiety disorder: a group of disorders characterized by fear or anxiety, accompanied by physiological arousal, and related behavioral disturbances. - among the easiest to treat and offer some of the best chances for recovery
*types of schizophrenia
for many years, researchers divided schizophrenia into 5 subtypes: paranoid, catatonic, disorganized, undifferentiated, and residual. - this system does not differentiate in terms of prognosis, cause, or response to treatment and the undifferentiated type was merely a catchall for cases that are difficult to diagnose for those reasons ^, researchers proposed an alternative classification system: 1. positive schizophrenia symptoms: are additions to or exaggerations of normal thought processes and behaviors, including bizarre delusions and hallucinations. - more common when schizophrenia develops rapidly - associated w better adjustment before the onset and a better prognosis for recovery 2. negative schizophrenia symptoms: include the loss or absence of normal thought processes and behaviors, and appear as impaired attention, limited or toneless speech, at or blunted affect, and social withdrawal - more often found in slow-developing schizophrenia
1. generalized anxiety disorder
generalized anxiety disorder: an anxiety disorder characterized by persistent, uncontrollable, and free-floating, non-specified anxiety - sufferers experience fear or worries that are not focused on any specific threat, which is why it is referred to as generalized - chronic, uncontrollable, and lasts at least six months - may develop headaches, heart palpitations, dizziness, and insomnia because of persistent muscle tension. (this makes it harder to cope with daily activities) - affects twice as many women as men
*studying psychological disorders*
how to distinguish normal or abnormal behaviors
*identifying and explaining psychological disorders
mental health professionals agree on four criteria for identifying abnormal behavior (aka psychopathology: patterns of behaviors, thoughts, or emotions considered pathological (diseased or disordered) for one or more of these four reasons: deviance, dysfunction, distress, or danger) - note that abnormal behavior (intelligence or creativity) is not composed of 2 discrete categories - "normal" and "abnormal". mental health lies along a continuum, w people being unusually healthy at one end and extremely disturbed at the other - no single criterion is adequate for identifying all forms of abnormal behavior - when considering the two criteria, deviance and danger, judgements of what is deviant vary historically and cross-culturally and that the public generally overestimates the danger posed by the mentally ill what causes abnormal behaviors and their therapies? - read paragraph on pg 443 pinel's medical model gave rise to modern specialty of psychiatry - medical model" the diagnostic perspective which assumes that diseases (including mental illness) have physical causes that can be diagnosed, treated, and possibly cured - psychiatry: the branch of medicine that deals with the diagnosis, treatment, and prevention of mental disorders thomas scasz: - labeling people as mentally ill encourages people to believe they have little or no responsibility for their actions - mental illness is a myth used to label individuals who are peculiar or offensive to others, and that these labels can become self- perpetuating (a person may begin to behave according to their diagnosed disorder) - the public may develop negative attitudes about mentally ill people and mental illnesses in general (ex: mass shooting can prompt intense debate over gun control and violence in the media - people can characterize his actions as those of the mentally ill) *look at 14.2 pg 445
*avoiding ethnocentrism (evaluation of other cultures according to preconceptions originating in the standards and customs of one's own culture.)
most research on psychological disorders originates and is conducted primarily in Western cultures - can limit our understanding of disorders in general and can lead to an ethnocentric view of mental disorders - cross-cultural researchers have devised ways to overcome these difficulties culture-bound symptom: - people learn to express their problems in ways that are acceptable to others in the same culture - ex: vietnamese and chinese respondents reported "fullness in head," mexican respondents noted "problems with [their] memory," and anglo-american respondents reported "shortness of breath" and "headaches." certain symptoms of depression (intense sadness, poor concentration, and low energy) seem to exist across all cultures - but there is evidence of some culture-bound symptoms (ex: feelings of guilt are found more often in north america and europe than in other parts of the world. in china, somatization (the conversion of depression into bodily complaints) occurs more frequently than it does in other parts of the world) mental disorders are sometimes culturally bound and generally only appear in one population group - ex: windigo psychosis, a disorder limited to a small group of Canadian Indians, illustrates just such a case.
*obsessive-compulsive disorder (OCD)
obsessive compulsive disorders (OCD): a mental disorder characterized by persistent, unwanted, fearful thoughts (obsessions), and/or irresistible urges to perform repetitive or ritualized behaviors (compulsions) OCD involves persistent, unwanted, fearful thoughts (obsessions) and/or irresistible urges to perform an act or repeated rituals (compulsions) to help relieve the anxiety created by the obsession. - in adults, women are affected at a slightly higher rate than men, whereas men are more commonly affected in childhood - most often treated with a combination of drugs and cognitive-behavior therapy - most sufferers realize that their actions are senseless but when they try to stop the behavior, they experience mounting anxiety, which is relieved only by giving in to the compulsions. 1. examples of obsessions: - fear of germs - fear of being hurt or of hurting others - troubling religious or sexual thoughts 2. examples of compulsions: - repeatedly checking, counting, cleaning, washing all or specific body parts, or putting things in a certain order - people with OCD have these thoughts and do these rituals for at least an hour or more each day, often longer (ex: person worries so obsessively about germs that they compulsively wash their hands hundreds of times a day, until they are raw and bleeding)
2. panic disorder
panic disorder: an anxiety disorder in which sufferers experience sudden and inexplicable panic attacks; symptoms include difficulty breathing, heart palpitations, dizziness, trembling, terror, and feelings of impending doom. - generally happen after frightening experiences or prolonged stress (sometimes, even after exercises) - panic disorder is diagnosed when several apparently spontaneous panic attacks lead to a persistent concern about future attacks - common complication of panic disorder is agoraphobia (people with agoraphobia restrict their normal activities because they fear having a panic attack in crowded, enclosed, or wide-open places where they would be unable to receive help in an emergency)
*culture and schizophrenia
peoples of different cultures experience mental disorders in a variety of ways. - ex: the reported incidence of schizophrenia varies in different cultures around the world. unclear whether these differences result from actual differences in prevalence of the disorder or from differences in definition, diagnosis, or reporting (symptoms of it also varies as well as stressors) despite the advanced treatment facilities and methods in industrialized nations, the prognosis for people with schizophrenia is actually better in non-industrialized societies. - reason: the core symptoms of schizophrenia (poor rapport with others, incoherent speech, and so on) make it more difficult to survive in highly industrialized countries. - also, in most industrialized nations, families and other support groups are less likely to feel responsible for relatives and friends who have schizophrenia
*personality disorders
personality disorders: a mental disorder characterized by chronic, inflexible, maladaptive personality traits, which cause significant impairment of social and occupational functioning. - the characteristics of a personality are so inflexible and maladaptive that they significantly impair someone's ability to function several types of personality disorders are included in this category in the fifth edition of the DSM - BUT we r only focusing on antisocial personality disorder and borderline personality disorder
3. phobias
phobia: a persistent and intense, irrational fear and avoidance of a specific object or situation that are usually considered relatively harmless - ex: elevators, dentist - although person recognizes that the level of fear is irrational, the experience is still one of overwhelming anxiety and a full blown panic attack may follow the DSM divides phobias into separate categories: agoraphobia, specific phobias, and social anxiety disorder - agoraphobia: people with agoraphobia restrict their normal activities because they fear having a panic attack in crowded, enclosed, or wide-open places where they would be unable to receive help in an emergency (severe cases: people w it may be too afraid to leave the safety of their home) - specific phobia: a fear of a specific object or situation, such as needles, rats, spiders, or heights. (claustrophobia (fear of closed spaced) and acrophobia (fear of heights) are the specific phobias most often treated by therapists) - people with specific phobias generally recognize that their fears are excessive and unreasonable, but they are unable to control their anxiety and will go to great lengths to avoid the feared stimulus. people w phobias have such extreme reactions bc they perceive the objects as being larger than they actually are - ex: researchers in one study asked people with spider phobias to stand beside a glass tank and observe five different tarantulas. they were then asked to estimate the size of each tarantula by drawing a line on an index card to illustrate its length. those who reported experiencing the highest levels of fear while standing beside the tank drew the longest lines. - social anxiety disorder: (or social phobia): irrationally fearful of embarrassing themselves in social situations. - fear of public speaking and eating are the two most common social phobias - the fear of public scrutiny and potential humiliation may become so pervasive that normal life is impossible
1. biological factors
plays a significant role in both depressive and bipolar disorders , and recent research suggests that structural brain changes may contribute to these disorders 1) some pro athletes are at a greater risk of developing such disorders as they age, possibly due to brain damage caused by repeated concussions (recent study on former NFL players revealed that 41% show cognitive problems and 24% show clinical depression, which may result from neurological changes caused by concussions) - their brain scans also revealed changes in blood flow within the brain and abnormalities in various parts of the brain = contribute to serious depression and increased risk of suicide 2) other research points to imbalances of the neurotransmitters serotonin, norepinephrine, and dopamine as possible causes of mood disorders - both depressive disorders and bipolar disorders are sometimes treated with antidepressants, which affect the amount or functioning of these same neurotransmitters - *an interesting side note, researchers in one study found that people who regularly ate fast food and commercially produced baked goods (such as croissants and doughnuts) were 51% more likely to develop depression later on = chemicals in bad food can lead to psychological changes in the brain and the body 3) depressive and bipolar disorders may be inherited 4) in contrast to ^^, research that takes an evolutionary perspective suggests that moderate depression may be normal and healthy adaptive response to a very real loss (death of a loved one), which helps us step back and reassess our goals - clinical, severe depression may just be an extreme version of this generally adaptive response
1. biological theories:
prenatal stress and viral infections, birth complications, immune responses, maternal malnutrition, and advanced paternal age all may contribute to the development of schizophrenia - however, most biological theories of schizophrenia focus on genetics, neurotransmitters, and brain abnormalities: 1) genetics: - most genetic studies have focused on twins and adoptions - research indicates that the risk for schizophrenia increases with genetic similarity (people who share more genes with a person who has schizophrenia are more likely to develop the disorder) 2) neurotransmitters: - according to the dopamine hypothesis, overactivity of certain dopamine neurons in the brain causes some forms of schizophrenia - this hypothesis is based on two observations: 1. administering amphetamines increases the amount of dopamine and can produce (or worsen) some symptoms of schizophrenia, especially in people with a genetic predisposition to the disorder. 2. drugs that reduce dopamine activity in the brain reduce or eliminate some symptoms of schizophrenia. 3) brain abnormalties: - looks at abnormalities in brain function and structure. - larger cerebral ventricles (fluid- filled spaces in the brain) and right hemisphere dysfunction in some people with schizophrenia - some people with chronic schizophrenia have a lower level of activity in their frontal and temporal lobes—areas we use in language, attention, and memory - this lower level of brain activity, and schizophrenia itself, may also result from an overall loss of gray matter (neurons in the cerebral cortex) - but the fact that the heritability of schizophrenia is only 48% even in identical twins—who share identical genes—tells us that non-genetic factors must contribute the remaining percentage
2. psychosocial factors
psychosocial theories of depression focus on environmental stressors, disturbances in the person's interpersonal relationships or self-concept, and on any history of abuse or assault - psychoanalytic explanation: sees depression as the result of experiencing a real or imagined loss, which is internalized as guilt, shame, self-hatred and ultimately self-blame - cognitive perspective explanation: explains depression as caused, at least in part, by negative thinking patterns, including a tendency to ruminate, or obsess, about problems - humanistic school says that depression results from when a person demands perfection of themselves or when positive growth is blocked learned helplessness: seligman's term for a state of helplessness or resignation, in which human or nonhuman animals learn that escape from something painful is impossible; the organism stops responding and may become depressed - learned helplessness theory: depression occurs when people (and other animals) become resigned to the idea that they are helpless to escape from something painful - may be particularly likely to trigger depression if the person attributes failure to causes that are internal ("my own weakness"), stable ("this weakness is long-standing and unchanging), and global ("this weakness is problem in lots of settings") - some people who suffer with these disorders are so disturbed that they lose contact with reality, they may fail to recognize the danger signs or to seek help = sometimes leads to suicide
1. psychological factors
researchers generally agree on the two major psychological contributions to anxiety disorders: faulty cognitive processes and maladaptive learning 1. cognitive processes: - people w anxiety disorders tend to have habits of thinking, or cognitive processes, that make them prone to fear - these faulty cognitions tend to make them hypervigilant (they constantly scan their environment for signs of danger and ignore signs of safety) - also tend to magnify ordinary threats and failures and to be hypersensitive to others' opinions of them 2. maladaptive learning: - learning theorists suggest that anxiety disorders result from maladaptive learning such as inadvertent and improper conditioning and social learning (classical conditioning, if a stimulus that is originally neutral (such as a harmless spider) becomes paired with a frightening event (a sudden panic attack), it becomes a conditioned stimulus that elicits anxiety. the person then begins to avoid spiders in order to reduce anxiety (an operant conditioning process known as negative reinforcement)) - conditioning may not always be the explanation bc some people do not know the exact instance that led them to the fear - some phobias result from modeling and imitation (ex: children whose parents, especially fathers, are afraid of going to the dentist are much more likely to also have such a fear themselves)
*symptoms of schizophrenia
schizophrenia is a group of disorders characterized by a disturbance in one or more of the following areas: perception, language, thought, affect (emotions), and behavior.
*schizophrenia*
schizophrenia: a group of severe disorders involving major disturbances in perception, language, thought, emotion, and behavior - one of the most widespread and devastating mental disorders - approximately 1 of every 100 people will develop it in his or her lifetime, and approximately half of all people who are admitted to mental hospitals are diagnosed with this disorder - usually emerges between the late teens and the mid 30s and only rarely prior to adolescence or after age 45 - equally prevalent in men and women, but its more severe and strikes earlier in men - people w it have serious problems caring for themselves, relating to others, and holding a job - extreme cases: the illness is considered a psychosis (the person is out of touch w reality, and treatment often requires institutional or custodial care) (example: he now also talks to himself — mumbling and yelling out at times — and no longer regularly showers or washes his hair. recently he announced, "The voices are telling me to jump out the window") many people confuse schizophrenia with dissociative identity disorder (sometimes referred to as split personality or multiple personality disorder) - schizophrenia means "split mind" - when eugen bleuler coined the term in 1911, he was referring to the fragmenting of thought processes and emotions, not of personalities
*explaining anxiety disorders
the psychological, biological, and sociocultural processes on why people develop anxiety disorders (the biopsychosocial model)
1. perception
the senses of people with schizophrenia may be either enhanced or blunted - the filtering and selection processes that allow most people to concentrate on whatever they choose are impaired, and sensory stimulation is jumbled and distorted - people with schizophrenia may also experience hallucinations, false, imaginary sensory perceptions that occur without external stimuli - auditory hallucinations (hearing voices and sounds) is one of the most commonly noted and reported symptoms - rare occasions: people with schizophrenia hurt others in response to their distorted perceptions. BUT a person w it is more likely to be self destructive and suicidal than violent toward others
*other disorders*
three additional disorders: obsessive-compulsive, dissociative, and personality disorders
*understanding and evaluating the DSM
to understand a disorder, we must first name and describe it - the DSM identifies and describes the symptoms of approximately 400 disorders, which are grouped into 22 categories (table 14.1 pg. 447) *we focus on 7 in this ch - note that the 22 categories are based on groups that share common, key features. (ex: generalized anxiety disorder, panic disorder, and phobias are all classified under "anxiety disorders" because their main symptom is excessive anxiety) - can be overlapping among the categories and people may be diagnosed with more then one disorder at a time = comorbidity: the co-occurrence of two or more disorders in the same person at the same time, as when a person suffers from both depression and alcoholism classification and diagnosis of mental disorders are essential to scientific study - w/o systems like the DSM, we could not effectively identify and diagnose the wide variety of disorders, predict their future courses, or suggest appropriate treatment. - The DSM also facilitates communication among professionals and those suffering from mental disorders and their families. In addition, it serves as a valuable educational tool. the DSM does have limitations and potential problems - ex: critics suggest that it may be casting too wide a net and overdiagnosing - therefore insurance companies compensate physicians and psychologists only if each client is assigned a specific DSM code number which is how compliers of the DSM may be encourages to add more diagnoses - criticized for a potential cultural bias - does provide a culture-specifc section and a glossary of culture-bound syndromes but the overall classification still reflects a Western European and U.S. perspective - overreliance on the medical model, and the way it may unfairly label people. (ex: classic study conducted by David Rosenhan (1973) in which he and his seven colleagues presented themselves at several hospital admissions of offices complaining of hearing voices (a classic symptom of schizophrenia). Aside from making this single false complaint, and providing false names and occupations, the researchers answered all questions truthfully. given their reported symptom, they were all diagnosed with mental disorders and admitted to the hospital. Once there, the "patients" stopped reporting any symptoms and behaved as they normally would, yet none were ever recognized by hospital staff as phony because once the volunteers in this study were labeled with schizophrenia, the staff interpreted all of their behaviors as abnormal. For example, hospital workers labeled one pseudopatient's habit of taking notes as evidence of his paranoia. they were released after 19 days but w a label on their permanent record of "schizophrenia in remission.") - labels are dangerous in a person's life bc stigma, prejudice, and discrimination surrounding mental illness may create lifetime career and social barriers for those who are already struggling with the psychological disorder itself. - on the other hand, the diagnostic labels in the DSM-5 are essential to professional treatment and communication.
*gender and cultural effects*
windigo/wiitiko psychosis: believe that they have been possessed by the spirit of a windigo, a cannibal giant with a heart and entrails of ice, victims become severely depressed - characterized by delusions and cannibalistic impulses - typically experiences loss of appetite, diarrhea, vomiting, and insomnia, and may see people turning into beavers and other edible animals. - later stages: victim becomes obsessed with cannibalistic thoughts and may even attack and kill loved ones in order to devour their flesh in this section: - discuss the complexities and problems with defining, identifying, and classifying abnormal behavior. - how gender and cultures are huge factors - how men and women differ in their experience of abnormal behavior. - look at cultural variations in abnormal behavior.
2. language and thought
words lose their usual meanings and associations, logic is impaired, and thoughts are disorganized and bizarre. - mild: when language and thought disturbances are mild, the individual jumps from topic to topic. - more severe: the person jumbles phrases and words together (into a "word salad") or creates artificial words. - most common and frightening: lack of contact with reality (psychosis). delusions: a false or irrational belief maintained despite clear evidence to the contrary - common - we all experience it but delusions of schizophrenia are much more extreme. - delusion of persecution: thinking someone is trying to harm u (ex: if someone falsely believed that the postman who routinely delivered mail to their house every afternoon was a co-conspirator in a plot to kill him, it would likely qualify as a delusion of persecution.) - delusions of grandeur: people believe that they are someone very important, perhaps Jesus Christ or the Queen of England - delusions of reference: unrelated events are given special significance (ex: when a person believes a radio program is sending him or her special messages) recent trend among individuals suffering from various mental disorders: - join internet groups where they can share their experiences with others (ex: people with schizophrenia and other psychotic disorders can now share with fellow sufferers their belief that they are being stalked or that their minds are being controlled by technology.) - internet groups can be helpful but can also reinforce troubled thinking and disrupt treatment - those who use the sites report feeling relieved by the sense that they are not alone in their suffering, but the groups are not moderated by professionals and pose the danger of amplifying the symptoms of mentally ill individuals
2. borderline personality disorder
*read example paragraph borderline personality disorder (BPD): a mental disorder characterized by severe instability in emotion and self-concept, along with impulsive and self- destructive behaviors. - classic symptoms: truancy, promiscuity, disrupted relationships, and self-destructive behaviors - most commonly diagnosed and most functionally disabling of all mental disorders core features of this disorder are impulsivity and instability in mood, relationships, and self-image - experience extreme difficulties in relationship bc of chronic feelings of depression, emptiness, and intense fear of abandonment - engage in destructive, impulsive behaviors, such as sexual promiscuity, drinking, gambling, and eating sprees. - may attempt suicide and sometimes engage in self-mutilating behavior - tend to see themselves and everyone else in absolute terms— as either perfect or worthless - may quickly erupt in anger at the slightest sign of disapproval bc always seeking reassurance from others - disorder marked by a long history of broken friendships, divorces, and lost jobs. - have a deep well of intense loneliness and a chronic fear of abandonment and they often seek therapy but bc of their troublesome persona, friends, lovers, and even family members and therapists often do "abandon" them—thus creating a tragic self-fulfilling prophecy. BPD can be reliably diagnosed and it does respond to professional intervention—particularly in young people causes of BPD: - environmental: childhood history of neglect, emotional deprivation, and physical, sexual, or emotional abuse - biological: tends to run in families, and is a result of impaired functioning of the brain's frontal lobes and limbic system, areas that control impulsive behaviors (ex: research using neuroimaging reveals that people with BPD show more activity in parts of the brain associated with the experience of negative emotions, coupled with less activity in parts of the brain that help suppress negative emotion) *BPD results from an interaction between the environment and biology
2. biological factors
- some researchers believe phobias reflect an evolutionary predisposition to fear things that were dangerous to our ancestors - some people with panic disorder also seem genetically predisposed toward an overreaction of the automatic nervous system (biological component) - stress and arousal, drugs, such as caffeine or nicotine, and even hyperventilation can trigger an attack (biochemical disturbances)
3. sociocultural factor
- there has been a sharp rise in anxiety disorders in the past 50 years, esp in western industrialized countries = our fast paced lives along with our increased mobility, decreased job security, and decreased family support might contribute to anxiety - unlike the dangers early humans faced in our evolutionary history, today's threats are less identifiable and less immediate = lead some people to become hypervigilant and predisposed to anxiety disorders - anxiety disorders can have dramatically different forms in other cultures (ex: in a collectivist twist on anxiety, some japanese experience a type of social phobia called taijin kyofusho (TKS): a morbid dread of doing something to embarrass others
*describing depressive and bipolar disorders
1) depressive disorders: a group of mental disorders, including major depressive disorder, characterized by sad, empty, irritable moods that interfere with the ability to function - people suffering are so deeply sad and discouraged that they often have trouble sleeping, are likely to lose (or gain) significant weight, and may feel so fatigued that they cannot go to work or school, or even comb their hair or brush their teeth. - may sleep constantly, have problems concentrating, and feel so profoundly sad and guilty that they consider suicide - seriously depressed people have a hard time thinking clearly or recognizing their own problems. - when depression is unipolar, and the depressive episode ends, the person generally returns to a normal emotional level. 2) bipolar disorder: a mental disorder characterized by repeated episodes of mania (unreasonable elation, often with hyperactivity) alternating with depression - people with bipolar disorders, however, rebound to the opposite state of a normal emotional level, known as mania. (look at fig 14.5) - during a manic episode, the bipolar person is overly excited and easily distracted - they might exhibit unrealistically high self esteem and an inflated sense of importance, and poor judgement (ex: giving away valuable possessions or going on wild spending sprees) - person is also often hyperactive and may not sleep for days at a time yet does not become fatigued - thinking is faster than normal and can change abruptly to new topics, showing "rapid flight of ideas" - speech is also rapid (pressured speech), making it difficult for others to get a word in - a manic episode may last a few days or a few months and it'll generally end abruptly - the ensuing depressive episode generally lasts three times as long - the lifetime risk for bipolar disorder is low (between 0.5 and 1.6%) but it can be one of the most debilitating and lethal disorder, with a suicide rate between 10-20% *suicide is also a serious risk for anyone suffering from several other mental health issues part. depressive disorders
*describing anxiety disorders
3 anxiety disorders: 1. generalized anxiety disorder (GAD) 2. panic disorder 3. phobias *covered separately but two or more often occur together
*classifying psychological disorders
Diagnostic and Statistical Manual of Mental Disorders: a classification system developed by the american psychiatric association that is used to describe abnormal behaviors - revised several times and the latest, 5th edition, was published in 2013 - each revision expanded the list of disorders and changes the descriptions and categories to reflect both the latest in scientic research and any changes in the way abnormal behaviors are viewed within our social context - ex: neurosis (an outmoded term and category dropped from the DSM, in which a person does not have signs of brain abnormalities and does not display grossly irrational thinking or violate basic norms, but does experience subjective distress) ; have been formally studied and redistributed as separate categories. - ex: psychosis (a serious mental disorder characterized by extreme mental disruption and defective or lost contact with reality.) ; kept in the current edition of the DSM bc it remains useful for distinguishing the most severe mental disorders, such as schizophrenia. - ex: insanity (the legal (not clinical) designation for the state of an individual judged to be legally irresponsible or incompetent to manage his or her own affairs because of mental illness.) - in the law, the definition of mental illness rests primarily on a person's inability to tell right from wrong