unit 12 psychology

what is dissociative identity disorder? What are the symptoms of it?

1. A massive dissociation of self from ordinary consciousness characterizes those with DISSOCIATIVE IDENTITY DISORDER (DID) a) Dissociative identity disorder (DID): a rare dissociative disorder in which a person exhibits two or more distinct and alternating personalities. Formerly called multiple personality disorder 2. Each personality has its own voice and mannerisms a) Thus the person may be prim and proper one moment, loud and flirtatious the next b) Typically, the original personality denies any awareness of the other(s) c) People diagnosed with DID (formerly called multiple personality disorder) are usually not violent, but cases have been reported of dissociations into a "good" and a "bad" (or aggressive) personality-a modest version of the Dr. Jekyll/Mr. Hyde split immortalized in Robert Louis Steveson's story 3. One unusual case involved Kenneth Bianchi, accused in the "Hillside Strangler" rapes and murders of 10 California women a) During a hypnosis session with Bianchi, psychologist John Watkins called forth a hidden personality: "I've talked a bit to Ken, but I think that perhaps there might be another part of Ken that maybe feels somewhat differently from the part that I've talked to..Would you talk with me, part, by saying 'I'm here?" b) Bianchi answered "yes" and then claimed to be "steve." c) Speaking as Steve, Bianchi stated that he hated Ken because Ken was nice and that he (steve), aided by a cousin, had murdered women d) He also claimed Ken knew nothing about Steve's existence and was innocent of the murders e) Was Bianchi's second personality a ruse, simply a way of disavowing responsibility for his actions? f) Indeed, Bianchi-a practiced liar who had read about multiple personality in psychology books-was later convicted 4. Diagnosis and Symptoms a) The same individual possesses two or more distinct personalities b) Each personality has unique memories, behaviors, and relationships c) Only one personality is dominant at a time

Who is most vulnerable to psychological disorders at what times of life?

1. The prevalence of psychological disorders are highest in the US and women are more likely to be diagnosed with men a) Men get diagnosed with male "disorder" (antisocial disorder) and women are more likely diagnosed with "female" disorders (histrionic) b) Sex plays a larger role than symptoms 2. Who is most vulnerable to psychological disorders? At what times of life? a) To answer such questions, various countries have conducted lengthy, structured interviews with representative samples of thousands of their citizens b) After asking hundreds of questions that probed for symptoms -"has there ever been a period of two weeks or more when you felt like you wanted to die?"-the researchers have estimated the current, prior-year, and lifetime prevalence of various disorders c) The answer varies with the disorder d) One predictor of mental disorder, poverty, crosses ethnic and gender lines e) The incidence of serious psychological disorders has been doubly high among those below the poverty line f) Like so many other correlations, the poverty disorder association raises a chicken and egg question: does poverty cause disorders or do disorders cause poverty? g) It is both, thought the answer varies with the disorder h) Schizophrenia understandably leads to poverty i) Yet the stresses and demoralization of poverty can also precipitate disorders, especially depression in women and substance use disorder in men j) In one natural experiment on the poverty-pathology link, researchers tracked rates of behavior problems in North Carolina Native American children as economic development enabled a dramatic reduction in their community's poverty rate k) As the study began, children of poverty exhibited more deviant and aggressive behaviors l) After four years, children whose families had moved about the poverty line exhibited a 40 percent decreases in the behavior problems, while those who continued in their previous positions below or above the poverty line exhibited no change 3. At what times of life do disorders strike? a) Usually by early adulthood b) Over 75% of our sample with any disorder had experienced its first symptoms by age 24 reported Lee Robins and Darrel Regier c) The symptoms of antisocial personality disorder and of phobias are among the earliest to appear, at a median age of 8 and 10, respectively d) Symptoms of alcohol use disorder, obsessive compulsive disorder, bipolar disorder, and schizophrenia appear at a median age near 20 e) Major depression often hits somewhat later, at a median age of 25 f) Such findings make clear the need for research and treatment to help the growing number of people, especially teenagers and young adults, who suffer the bewilderment and pain of a psychological disorder g) Although mindful of the pain, we can also be encouraged by the many successful people-including Leonardo da Vinci, Issac Newton, and Leo Tolstoy-who pursued brilliant careers while enduring psychological difficulties h) So have 18 US presidents, including the periodically depressed Abraham Lincoln, according to one psychiatric analysis of their biographies i) The bewilderment, fear, and sorrow caused by psychological disorders are real

what is the biological perspective to anxiety disorders?

1. There is, however, more to anxiety, OCD, and PTSD than conditioning, observational learning, and cognition a) The biological perspective can help us understand why fear people develop lasting phobias after suffering traumas, why we learn some fears more readily and why some individuals are more vulnerable 2. Natural selection has led our ancestors to learn to fear snakes, spiders, and other animals. Therefore, fear preserves the species a) If things are a threat to our lives and have been for a long time, our ancestors past down those fears to us through natural selection b) Some fears have been adapted to fit the new environment-checking doors today is the old checking boundaries. c) Anxiety from fear can cause you to pick at your skin or hair and it may have been the old type of grooming d) We humans seem biologically prepared to fear threats faced by our ancestors e) Our phobias focus on such specific fears: spiders, snakes, and other animals; enclosed spaces and heights; storms and darkness f) Those fearless about these occasional threats were less likely to survive and leave descendants g) Thus, even in Britain, with only one poisonous snake species, people often fear snakes h) And preschool children more speedily detect snakes in a scene than flowers, caterpillars, or frogs i) It is easy to condition and hard to extinguish fears of such evolutionary relevant stimuli 3. Our modern fears can also have an evolutionary explanation a) For example, a fear of flying may come from our biological predisposition to fear confinement and heights b) Moreover, consider what people tend not to learn to fear c) World War II air raids produced remarkably few lasting phobias d) As the air blitzes continued, the British, Japanese, and German populations became not more panicked, but rather more indifferent to planes outside their immediate neighborhoods e) Evolution has not prepared us to fear bombs dropping from the sky 4. Just as our phobias focus on dangers faced by our ancestors, our compulsive acts typically exaggerate behaviors that contributed to our species; survival a) Grooming gone wild becomes hair pulling b) Washing up becomes ritual hand washing c) Checking territorial boundaries becomes rechecking an already locked door 5. Twin studies suggest that our genes may be partly responsible for developing fears and anxiety. Twins are more likely to share phobias a) Some people are more anxious than others b) Genes matter c) Pair a traumatic event with a sensitive, high strung temperament and the result may be a new phobia d) Some of us have genes that make us like orchids-fragile, yet capable of beauty under favorable circumstances e) Others of us are like dandelions-hardy and able to thrive in varied circumstances f) Among monkeys, fearfulness runs in families g) Individual monkeys react more strongly to stress if their close biological relatives are anxiously reactive h) In humans, vulnerability to anxiety disorders rises when an afflicted relative is an identical twin i) Identical twins also may develop similar phobias, even when raised separately j) One pair of 35 year old female identical twins independently became so afraid of water that each would wade in the ocean backward and only up to the knees k) Given the genetic contribution to anxiety disorders, researchers are now sleuthing the culprit genes l) One research team has identified 17 genes that appear to be expressed with typical anxiety disorder symptoms m) Other teams have found genes associated specifically with OCD n) Genes influence disorders by regulating neurotransmitters o) Some studies point to an anxiety gene that affects brain levels of serotonin, a neurotransmitter that influences sleep and mood p) Other studies implicate genes that regulate the neurotransmitter glutamate q) With too much glutamate, the brain's alarm centers become overactive 6. Generalized anxiety, panic attacks, and even OCD are biologically measurable and linked with brain circuits like the anterior cingulate cortex a) Generalized anxiety, panic attacks, PTSD, and even obsessions and compulsions are manifested biologically as an overarousal of brain areas involved in impulse control and habitual behaviors b) When the disordered brain detects that something is amiss, it seems to generate a mental hiccup of repeating thoughts or actions c) Brain scans of people with OCD reveal elevated activity in specific brain areas during behaviors such as compulsive hand washing, checking, ordering, or hoarding d) The ANTERIOR CINGULATE CORTEX, a brain region that monitors our actions and checks for errors, seems especially likely to be hyperactive in those with OCD e) Fear learning experiences that traumatize the brain can also create fear circuits within the amygdala f) Some antidepressant drugs dampen this fear circuit activity and its associated obsessive compulsive behavior g) Fears can also be blunted by giving people drugs, such as propranolol or D-Cycloserine as they recall and then re record (reconsolidate) a traumatic experience h) Although they don't forget the experience, the associated emotion is largely erased

What can be a bigger risk factor for suicide?

1. They don't report suicides in the media because when it is reported, it causes lots of others (its almost contagious because they are thinking about it but seeing someone else kill themselves causes them to go through with their own plan) this is why the media doesn't inform others about it a) Publicizing suicide is especially dangerous because of social proof b) Auto and plane deaths increase after well publicized suicides...1000% c) The more publicity the more suicides (when celebrities kill themselves, suicides also go up) d) Within 2 months of every front page suicide 58 more people than usual killed themselves from 1947-1968 e) The risk of sucide is at least five times greater for those who have been depressed than for the general population 2. People seldom commit suicide while in the depths of depression, when energy and initiative are lacking a) The risk increases when they begin to rebound and become capable of following through b) Among people with alcohol use disorder, 3% die by suicide c) This rate is roughly 100 times greater than the rate for people without alcohol use disorder d) Because suicide is so often an impulsive act, environmental barriers (such as jump barriers on high bridges and the unavailability of loaded guns) can reduce suicides e) Although common sense might suggest that a determined person would simply find another way to complete the act, such restrictions give time for self destructive impulses to subside 3. Social suggestion may trigger suicide a) Following highly publicized suicides and TV programs featuring suicide, known suicides increase b) So do fatal auto and private airplane "accidents" c) One six year study tracked suicide cases among all 1.2 million people who lived in metropolitan Stockholm at any time during the 1990s d) Men exposed to a family suicide were 8 times more likely to commit suicide than were non-exposed men e) Although that phenomenon may be partly attributable to family genes, shared genetic predispositions do not explain why men exposed to a co-worker's suicide were 3.5 times more likely to commit suicide, compared with non-exposed men 4. Suicide is not necessarily an act of hostility or revenge a) The elderly sometimes choose death as an alternative to current or future suffering b) In people of all ages, suicide may be a way of switching off undesirable pain and relieving a received burden on family members c) People desire death when two fundamental needs are frustrated to the point of extinction, notes Thomas Joiner: the need to belong with or connection to others and the need to feel effective with or to influence others. d) Suicidal urges typically arise when people feel disconnected from others, and a burden to them or when they feel defeated and trapped by an inescapable situation e) Thus, suicide rates increase a bit during economic recessions f) Suicidal thoughts also may increase when people are drive to reach a goal or standard-to become thin o straight or rich-and find it unattainable g) In hindsight, families and friends may recall signs they believe should have forwarded them-verbal hints, giving possessions away, or withdrawal and preoccupation with death h) To judge from surveys of 84,850 people across 17 nations, about 9% of people at some point in their lives have thought seriously of suicide i) About 30% of these (3% of people) actually attempt it j) For only about 1 in 25 does the attempt become their final act k) Of those who die, one third had tried to kill themselves previously l) Most discussed it beforehand m) So, if a friend talks suicide to you, its important to listen and to direct the person to professional help n) Anyone who threatens suicide is at least sending a signal of feeling desperate or despondent

what is persistent depressive disorder?

Adults diagnosed with PERSISTENT DEPRESSIVE DISORDER (also called DYSTHYMIA) experience a mildly depressed mood more often than not for at least two years They also display at least two of the following symptoms: 1. Problems regulating appetite 2. Problems regulating sleep 3. Low energy 4. Low self esteem 5. Difficulty concentrating and making decisions 6. Feelings of hopelessness

what is the depression cycle?

CYCLE: 1. Negative stressful events interpreted through 2. A ruminating, pessimistic explanatory style create a) Taking the blame and not coping with the stressful event in a good way 3. A Hopeless depressed state a) Easier to become depressed if you believe that you do not have control over your life 4. These hamper the way the individual thinks and acts, fueling, negative, stressful experiences such as personal rejection NOTES: 5. Depression, as we have seen, is often brought on by stressful experiences-losing a job, getting divorced or rejected, suffering physical trauma-by anything that disrupts our sense of who we are and why we are worthy human beings a) This disruption in turn leads to brooding, which amplifies negative feelings b) But being withdrawn, self focused, and complaining can by itself elicit rejection 6. In one study, researchers Stephen Strack and James Coyne noted that depressed persons induce hostility, depression, and anxiety in others and got rejected a) Their guesses that they were not accepted were not a matter of cognitive distortion b) Indeed, people in the throes of depression are at high risk for divorce, job loss, and other stressful life events c) Weary of the person's fatigue, hopeless attitude, and lethargy, a spouse may threaten to leave or a boss may begin to question the person's competence (this provides another example of genetic environmental interaction: people genetically predisposed to depression more often experience depression events) d) The losses and stress only serve to compound the original depression e) Rejection and depression feed each other f) Misery may love another's company, but company does not love another's misery g) None of us is immune to the dejection, diminished self esteem, and negative thinking bright on by rejection or defeat 7. As Edward Hirt and his colleagues demonstrated, even small losses can temporarily sour our thinking a) They studied some avid Indiana University basketball fans who seemed to regard the team as an extension of themselves b) After the fans watched their team lose or win, the researches asked them to predict the team's future performance and their own c) After a loss, the morose fans offered bleaker assessments not only of the team's future but also of their own likely performance at throwing darts, solving anagrams, and getting a date d) When things aren't going out way, it may seem as though they never will e) It is a cycle we can all recognize. f) Bad moods feed on themselves g) When we feel down, we think negatively and remember bad experiences h) On the brighter side, we can break the cycle of depression at any of these points-by moving to a different environment, by reversing our self blame and negative attributions, buy turning our attention outward, or by engaging in more pleasant activities and more competent behavior i) Winston Churchill called depression a black dog that periodically hounded him j) Poet Emily Dickinson was so afraid of bursting into tears in public that she spent much of her adult life in seclusion k) As each of these lives reminds us, people can and do struggle through depression l) Most regain their capacity to love, to work, and even to succeed at the highest levels

What is major depressive disorder? How common is it compared to depression?

Major depressive disorder occurs when signs of depression last two weeks or more and are not caused by drugs or medical conditions a) It used to be longer than two weeks (it was like 90 days before) 1. Signs include: a) Lethargy and fatigue b) Feelings of worthlessness c) Loss of interest in family, friends and life d) Loss of interest in activities 2. MAJOR DEPRESSIVE DISORDER occurs when at least five signs of depression last two or more weeks a) Major depressive disorder: a mood disorder in which a person experiences, in the absence of drugs or another medical condition, two or more weeks with five or more symptoms, at least one of which must be either (1) depressed mood or (2) loss of interest or pleasure b) To sense what major depression feels like, suggest some clinicians, imagine combining the anguish of grief with the sluggishness of bad jet lag 3. Depression is the "common cold" of psychological disorders a) In a year, 5.8% of men and 9.5% of women report depression worldwide b) Women more likely than men are more willing to report depression since women express emotion more than men c) Depression does run in families d) If you are like most high school students, at some time during this year-more likely the dark months of winter than the bright days of summer-you will probably experience some of depression's symptoms e) You may feel deeply discouraged about the future, dissatisfied with your life, or socially isolated f) You may lack the energy to get things done or even to force yourself out of bed; be unable to concentrate, eat, or sleep normally; or even wonder if you would be better off dead. g) Perhaps academic success came easily to you in middle school, and now you find that disappointing grades jeopardize your goals h) Maybe social stresses, such as feeling you don't belong or experiencing the end of a romance, have plunged you into despair i) And maybe brooding has at times only worsened your self torment j) Likely you think you are more alone in having such negative feelings that you really are k) In one survey of American high school students, 29 % felt so sad or hopeless almost every day for 2 or more weeks in a row that they stopped doing some usual activities l) In another national survey, of American collegians, 31% agreed when asked if in the past year they had at some time felt so depressed that it was difficult to function m) Misery has more company than most suppose m) Although phobias are more common, depression is the number one reason people seek mental health services o) At some point during their lifetime, depression plagues 12% of Canadian adults and 17% of US adults p) Moreover, it is the leading cause of disability worldwide q) In any given year, a depressive episode plagues 5.8% of men and 9.5% of women, reports the World Health Organization 4. As anxiety is a response to the threat of future loss, depressed mood is often a response to past and current loss a) About one in four people diagnosed with depression is debilitated b a significant loss, such as a loved one's death, a ruptured marriage or a lost job b) To feel bad in reaction to profoundly sad events is to be in touch with reality. c) In such times, there is an upside to being down d) Sadness is like a car's low field light-a signal that warns us to stop and take appropriate measures e) Recall, that biologically speaking, life's purpose is not happiness but survival and reproduction f) Coughing, vomiting, swelling, and pain protect the body from dangerous toxins g) Similarly, depression is a sort of past hibernation: it slows us down, defuses aggression, helps us let go of unattainable goals, and restrains risk taking h) To grind temporarily to a halt and ruminate, as depressed people do, is to reassess one's life when feeling threatened, and to redirect energy in more promising ways i) Even mild sadness can improve people's recall, make them more discerning, and help them make complex decisions j) There is sense to suffering 5. But when does this response become seriously maladaptive? a) Joy, contentment, sadness, and despair are different points on a continuum, points at which any of us may be found at any given moment b) The difference between a blue mood after bad news and a mood disorder is like the difference between gasping for breath after a hard run and being chronically short of breath

what are the suspected causes of antisocial personality disorder?

1. Biological factors (genetic, brain) a) Antisocial personality disorder is woven of both biological and psychological strands b) No single gene codes for a complex behavior such as crime, but twin and adoption studies reveal that biological relatives of those with antisocial and unemotional tendencies are at increased risk for antisocial behavior c) Molecular geneticists have identified some specific genes that are more common in those with antisocial personality disorder d) The genetic vulnerability of people with antisocial and unemotional tendencies appears as a fearless approach to life e) Awaiting aversive events, such as electric shocks or loud noises, they show little autonomic nervous system arousal 2. Long term studies have shown that their levels of stress hormones were lower than the average when they were youngsters, before committing any crime a) Three year olds who are slow to develop conditioned fears are later more likely to commit a crime b) Other studies have found that preschool boys who later became aggressive or antisocial adolescents tended to be impulsive, uninhibited, unconcerned with social rewards, and low in anxiety c) If channeled in more productive directions, such fearlessness may lead to courageous heroism, adventurism, or star level athleticism d) Lacking a sense of social responsibility, the same disposition may produce a cool con artist or killer 3. The genes that put people at risk for antisocial behavior also put people at risk for substance use disorders, which helps explain why these disorders often appear in combination a) Genetic influences, often in combination with child abuse, help wire the brain b) Adrain Raine compared PET scans of 41 murderers' brains with those from people of similar age an sex c) Raine found reduced activity in the murderers' frontal lobes, an area of the cortex that helps control impulsively d) In a follow up study, Raine and his team found that violent repeat offenders had 11% less frontal lobe tissue than normal e) This helps explain why people with antisocial personality disorder exhibit marked deficits in frontal lobe cognitive functions, such as planning, organization, and inhibition f) Compared with people who feel and display empathy, their brains also responded less to facial displays of others' distress g) A biologically based fearlessness, as well as early environment, helps explain the reunion of long separated sisters Joyce Lott 27 and Mary Jones 29-in a South Carolina prison where both were sent on drug charges. h) After a newspaper story about their reunion, their long lost half brother Frank Strickland called i) He explained it would be a while before he could come see them-because he, too, was in jail, on drug, burglary, and larceny charges j) PET scans of 41 murderers revealed reduced activity in the frontal lobes. In a follow up study, violent repeat offenders had 11% less frontal lobe activity 4. Genetics alone is hardly the whole story of antisocial crime, however a) A study of criminal tendencies among young Danish men illustrates the usefulness of a complete biopsychosocial approach b) Another Adrain Raine lef study checked criminal records of nearly 400 men at ages 20 to 22 knowing that these men neither had experienced biological risk factors at birth (such as premature birth) or came from family backgrounds marked by poverty and family instability c) The researchers then compared each of these two groups with a third biosocial group whose lives were marked by both the biological and social risk factors d) The biosocial group had doubled the risk of committing a crime e) Similar findings emerged from a famous study that followed 1037 children for a quarter century: two combined factors-childhood maltreatment and a gene that altered neurotransmitter balance-predicted antisocial problems f) Neither "bad' genes alone nor a "bad" environment alone predisposed later antisocial behavior g) Rather, genes predisposed some children to be more sensitive to maltreatment h) Within "genetically vulnerable segments of the population," environmental influences matter for better or for worse i) With antisocial behavior, as with so much else, nature and nurture interact and together leave their marks on the brain 5. To explore the neural basis of antisocial behavior, neuroscientists are identifying brain activity differences in criminals who display antisocial personality disorder a) Shown emotionally evocative photographs, such as a man holding a knife to a woman's throat, they display lower heart rate and perspiration responses and less activity in brain areas that typically respond to emotional stimuli b) They also display a hyper reactive dopamine reward system that predisposes their impulsive drive to do something rewarding, despite the consequences c) Such data provide another reminder: everything psychological is also biological

what is ADHD?

Attention deficit/hyperactivity disorder (ADHD): a psychological disorder marked by the appearance by age 7 of one or more of three key symptoms: extreme inattention, hyperactivity, and impulsivity 1. 11% of American 4 to 17 year olds who display symptoms of ADHD including extreme inattention, hyperactivity, and impulsivity a) Studies also find 2.5% of adults though a diminishing number with age exhibiting ADHD symptoms b) Psychiatry's new diagnostic manual lossens the criteria for adult ADHD leading critics to fear increased diagnosis and overuse of prescription drugs 2. To skeptics, being distractible, fidgety, and impulsive sounds like a "disorder" caused by a single genetic variation: a Y chromosome a) And sure enough ADHD is diagnosed three times more often in boys than in girls b) Does energetic child + borning school = ADHD overdiagnosis? Is the label being applied to healthy schoolchildren, who in more natural outdoor environments would seem perfectly normal c) Skeptics think so d) In the decades after 1987 they note the proportion of American children being treated for ADHD nearly quadrupled e) How commonplace the diagnosis is depends in part on teacher referrals f) Some teachers refer lots of kids for ADHD assessment, others none g) ADHD rates have varied by a factor of 10 in different counties of New York State h) Although African American youth display more ADHD symptoms than do Caucasian youth, they less often receive an ADHD diagnosis i) Depending on where they live, children who are a persistent pain in the neck in school are often diagnosed with ADHD and given powerful prescription drugs notes Peter Gray j) But the problem resides less in the child, he argues, than in today's abnormal environment that forces children to do what evolution has not prepared them to do-to sit for long hours in chairs 3. On the other side of the debate are those who argue that the more frequent diagnoses of ADHD today reflect increased awareness of the disorder, especially in those areas where rates are highest a) They acknowledge that diagnoses can be subjective and sometimes inconsistent-ADHD is not as objectively defined as is a broken arm b) Nevertheless, declared he World Federation for Mental health, there is strong agreement among the international scientific community that ADHD is a real neurobiological disorder whose existence should no longer be debated c) A consensus statement by 75 researchers noted that in neuroimaging studies, ADHD has associations with abnormal brain activity pattern 4. What then is known about ADHD's causes? a) It is not caused by too much sugar or poor schools b) There is mixed evidence suggesting that extensive TV watching and video gaming are associated with reduced cognitive self regulation and ADHD c) ADHD often coexists with a learning disorder or with defiant and temper prone behavior d) ADHD is heritable, and research teams are sleuthing the sculpting genes and abnormal neural pathways e) It is treatable with medications such as Ritalin and Adderall, which are considered stimulants but help calm hyperactivity and increase the ability to sit and focus on a task-and to progress normally in school f) Psychological therapies, such as those focused on shaping behaviors in the classroom and at home have also helped address the distress of ADHD 5. The bottom line: extreme inattention, hyperactivity, and impulsivity can derail social, academic, and vocational achievements, and these symptoms can be treated with medication and other therapies a) But the debate continues over whether normal rambunctiousness is too often diagnosed as a psychiatric disorder, and whether there is a cost to the long term use of stimulant drugs in treating ADHD

what is bipolar disorder?

Formerly called manic depressive disorder. a mood disorder in which a person alternates between the hopelessness and lethargy of depression and the overexcited state of mania 1. People can go in and be diagnosed with depression, but the depression pills kick them into a manic episode a) With or without therapy, episodes of major depression usually end, and people temporarily or permanently return to their previous behavior patterns b) However, some people rebound to, or sometimes start with, with the opposite emotional extreme-the euphoric, hyperactive, wildly optimistic state of MANIA 2. Mania: a mood disorder marked by a hyperactive, wildly optimistic state a) If depression is living in slow motion, mania is fast forward b) Alternating between depression and mania (week to week, and not day to day or moment to moment) signals BIPOLAR DISORDER 3. Depressive symptoms a) Gloomy b) Withdrawn c) Inability to make decisions d) Tired e) Slowness of thought 4. Mania symptoms: a) Elation b) Euphoria c) Desire for action d) Hyperactive e) Multiple ideas f) Mania and depressive symptoms usually last several months to a year. Mania usually brings you into the ER and they will probably rack up debt and quit their job because they feel so positive and good (it is delusional thinking) 5. Adolescent mood swings, from rage to bubbly, can when prolonged, produce a bipolar diagnosis a) Between 1994 and 2003, US National Center for Health Statistics annual physician surveys revealed an astonishing 40 fold increase in diagnoses of bipolar disorder in those 19 and under from an estimated 20,000 to 800,000 b) The new popularity of the diagnosis, given in two thirds of the cases to boys, has been a boon to companies whose drugs are prescribed to lessen mood swings c) The DSM-5 will likely reduce the number of child and adolescent bipolar diagnosis, by classifying as disruptive mood dysregulation disorder some of those with emotional volatility d) During the manic phase, people with bipolar disorder are typically over talkative, overactive and elated (though easily irritated) have little need for sleep, and show fewer sexual inhibitions e) Speech is loud, flighty, and hard to interrupt f) They find advice irritating g) Yet they need protection from their own poor judgment, which may lead to reckless spending or unsafe sex 6. In milder forms, mania's energy and free flowing thinking does fuel creativity a) George Frideric Handel, who may have suffered from a mild form of bipolar disorder, composed his nearly four hour long Messiah during three weeks of intense, creative energy b) Robert Schumann composed 51 musical works during two years of mania and none during 1844 when he was severely depressed c) Those who rely on precision and logic, such as architects, designers, and journalists, suffer bipolar disorder less often than do those who rely on emotional expression and vivid imagery d) Composers, artists, poets, novelists, and entertainers seem especially prone 7. It is as true of emotions as of everything else: what goes up comes down a) Before long, the elated mood either returns to normal or plunges into a depression b) Though bipolar disorder is much less common than major depressive disorder, it is often more dysfunctional, claiming twice as many lost workdays yearly c) Among adults, it afflicts men and women about equally

how do negative thoughts and negative moods interact with each other? What is rumination?

1. Explanatory style plays a major role in becoming depressed a) But why do life's inevitable failures lead only some people to become depressed? b) The answer lies partly in their EXPLANATORY STYLE- who or what they blame for their failures (or credit for their successes) c) So it is with depressed people, who tend to explain bad events in terms that are STABLE ("it's going to last forever"), GLOBAL( "It's going to affect everything I do") and INTERNAL ("it's all my fault) d) Depression prone people respond to bad events in an especially self focused, self blaming way e) Their self esteem fluctuates more rapidly up with boosts and down with threats f) The results of these pessimistic, overgeneralize,d self blaming attributions may be depressing sense of hopelessness g) As Martin Seligman has noted, a recipe for severe depression is pre existing pessimism encountering failure 2. Negative thoughts and negative moods interact Self defeating beliefs may arise from LEARNED HELPLESSNESS a) Both dogs and humans act depressed, passive, and withdrawn after experiencing uncontrollable painful events b) Learned helplessness is more common in women than in men and women may respond more strongly to stress c) For example, 38% of women and 17% of men entering US colleges and universities report feeling at least occasionally overwhelmed by all I have to do d) Men report spending more of their time in light anxiety activities such as sports, TV watching, and partying possibly avoiding activities that might make them feel overwhelmed e) This may help explain why, beginning in their early teens, women are nearly twice as vulnerable to depression 3. Susan Nolen Hoesema believed women's higher risk of depression relates to what she described as their tendency to overthink, to ruminate a) RUMINATION can be adaptive b) Rumination: compulsive fretting; overthinking about our problems and their causes c) But when it is relentless, self focused rumination divots us from thinking about other life tasks and produces a negative emotional inertia 4. What then might we expect of new college students who are not depressed but do exhibit a pessimistic explanatory style? a) Lauren Alloy and her collaborators monitored Temple University and University of Wisconsin students every 6 weeks for 2.5 years b) Among those identified as having a pessimistic thinking style, 17% had a first episode of major depression, as did only 1% of those who began college with an optimistic thinking style c) Seligman has contended that depression is common among young Westerners because the rise of individualism and the decline of commitment to religion and family have forced young people to take personal responsibility for failure or rejection d) In non-Western cultures, where close knit relationships and cooperation are the norm, major depression is less common and less tied to self blame over personal failure e) In Japan, for example, depressed people instead tend to report feeling shame over letting others down 5. There, is however, a chicken and egg problem with the social cognitive explanation of depression a) Self defeating beliefs, negative attributions, and self blame COINCIDE with a depressed mood and are INDICATORS of depression b) But do they cause depression> c) Before or after being depressed people's thoughts are less negative d) Perhaps this is because, as we noted in our discussion of state dependent memory, a depressed mood triggers negative thoughts e) If you temporarily put people in a bad or sad mood, their memories judgements and expectations suddenly become more pessimistic

can genes cause schizophrenia?

1. Genetic predisposition a) Fetal virus infections do appear to increase the odds that a child will develop schizophrenia b) But this theory cannot tell us why only 2% of women who catch the flu during their second trimester of pregnancy beat children who develop schizophrenia 2. Might people also inherit a predisposition to this disorder? a) The evidence strongly suggests that, yes, some do b) The nearly 1-in-100 odds of any person being diagnosed with schizophrenia become about 1 in 10 months whose sibling or parent has the disorder, and close to 1 in 2 if the affected sibling is an identical twin c) Although only a dozen or so such cases are on record, the co twin of an identical twin with schizophrenia retains that 1 in 2 chance even when the twins are reared apart d) Remember, though, that identical twins also share a prenatal environment e) About two thirds also share a placenta and the blood it supplies; the other one third have two single placentas f) If an identical twin has schizophrenia, the co-twin's chances of being similarly afflicted are 6 in 10 if they share a placenta g) If they had separate placentas, as do fraternal twins, the chances are only 1 in 10 h) Twins who share a placenta are more likely to experience the same prenatal viruses i) So it is possible that shared germs as well as shared genes produce identical twin similarities 3. Adoption studies, however, confirm that the genetic link is real a) Children adopted b someone who develops schizophrenia seldom catch the disorder b) Rather, adopted children have an elevated risk if a biological parent is diagnosed with schizophrenia c) With the genetic factor established, researchers are now sleuthing specific genes that, in some combination, might predispose schizophrenia inducing brain abnormalities (it is not our genes but our brains that directly control our behavior) 4. Some of these genes influence the effects of dopamine and other neurotransmitters in the brain a) Others affect the production of myelin, a fatty substance that coats the axons of nerve cells and lets impulses travel at high speed through neural networks b) Although the genetic contribution to schizophrenia is beyond question, the genetic formula is not as straightforward as the inheritance of eye color c) Genome studies of thousands of individuals with and without schizophrenia indicate that schizophrenia is influenced by many genes, each with very small effects d) Epigenetic (literally in addition to genetic) factors influence gene expression e) Like hot water activating the tea bag, environmental factors such as prenatal viral infections, nutritional deprivation, and maternal stress can turn on the genes that predispose schizophrenia f) Identical twins' differing histories in the womb and beyond explain why only one of them may show differing gene expressions g) As we have so often seen, nature and nurture interact 5. Thanks to our expanding understanding of genetic brain influences on maladies such as schizophrenia, the general public more and more attributes psychiatric disorders to biological factors a) In 2007, one privately funded new research center announced its ambitious aim: to unambiguously diagnose patients with psychiatric disorders based on their DNA sequence in 10 years time b) In 2010, $120 million in start up finding launched a bold new effort to study the neuroscience and genetics of schizophrenia and other psychiatric disorders c) So can scientists develop genetic tests that reveal who is at risk? d) If so will people in the future subject their embryos to genetic testing (and gene repair or abortion) if they are at risk for this or some other psychological or physical malady? e) Might they take their egg and sperm to a genetics lab for screening before combining them to produce an embryo? f) Or will children be tested or genetic risks and given appropriate preventive treatments? g) In this brave new 21st century world, such questions await answers

How can a depressed brain cause mood disorders?

1. PET scans show that brain energy consumption rises and falls with manic and depressive episodes a) Using modern technology, researchers are also gaining insight into brain activity during depressed and manic states, and into the effects of certain neurotransmitters during these states b) One study gave 13 elite Canadian swimmers the wrenching experience of watching a video of the swim in which they failed to make the Olympic team or failed at the Olympic games c) Functional MRI scans showed the disappointed swimmers experiencing brain activity patterns akin to those of patients with depressed moods 2. Many studies have found diminished brain activity during slowed down depressive states, and more activity during periods of mania a) The left frontal lobe and an adjacent brain reward center are active during positive emotions, but less active during depressed states b) In one study of people with severe depression, MRI scans also found their frontal lobes 7% smaller than normal c) Other studies show that the hippocampus, the memory processing center linked with the brain's emotional circuitry, is vulnerable to stress related damage 3. Bipolar disorder likewise correlates with brain structure a) Neuroscientists have found structural differences, such as decreased axonal white matter or enlarged fluid filled ventricles in the brains of people with bipolar disorder b) Neurotransmitter systems influence mood disorders c) Norepinephrine, which increases arousal and boosts mood, is scarce during depression and overabundant during mania d) Drugs that alleviate mania reduce norepinephrine e) Many people with a history of depression also have a history of habitual smoking, and smoking increases one's risk for future depression f) This may indicate an attempt to self medicate with inhaled nicotine, which can temporarily increase norepinephrine and boost mood g) Researchers are also exploring a second neurotransmitter, serotonin h) One well publicized study of New Zealand young adults found that the recipe for depression combined two necessary ingredients-significant life stress plus a variation of a serotonin controlling gene i) Depression arose from the interaction of an adverse environment plus a genetic susceptibility, but not from either alone j) But the story of gene environment interactions is still being written, as other researchers debate the reliability of this result 4. Drugs that relieve depression tend to increase norepinephrine or serotonin supplies by blocking either their reuptake (as Prozac, Zoloft, and paxil do with serotonin) or their chemical breakdown a) Repetitive physical exercise, such as jogging, reduces depression as it increase serotonin b) Boosting serotonin may promote recovery from depression by stimulating hippocampus neuron growth c) What's good for the heart is also good for the brain and mind d) People who eat a heart healthy mediterranean diet (heavy on vegetables, fish, and olive oil) have a comparatively low risk of developing heart disease, late life cognitive decline, and depression-all of which are associated with inflammation e) Excessive alcohol use also correlates with depression-mostly because alcohol misuse leads to depression

How common is PTSD?

1. If the symbols continue for four or more weeks is when there is trouble. It is normal to have nightmares about a scary event in the days following the event because dreams are how your brain processes information. a) Human beings are not made to kill other humans so doing it and seeing another person dead can mess with them. b) You can get secondary PTSD which is common among therapist because they hear about terrible things all of the time which causes them to experience PTSD related symptoms 2. The amount of prescription medicines for soldiers that have PTSD has increased by 800% a) PTSD can be missed in people (so it is underdiagnosed) but it is also overdiagnosed. Some people come in for treatment for substance use disorder but then discover that they coped with their PTSD but drinking/doing drugs b) Only about 10% of women and 20% of men react to traumatic situations and develop PTSD c) Could be genetic, biological sex difference, or because women have a social support system that men do not have 3. Holocaust survivors show remarkable resilience to traumatic situations a) Their hippocampus actually shrunk and the body blocks out events that are traumatic by literally shrinking the hippocampus so you don't have to remember it b) All major religions of the world suggest that surviving a trauma leads to the growth of an individual c) The worst the stressor, the more likely you are to develop PTSD 4. PTSD symptoms have also been reported by survivors of accidents, disasters, and violent and sexual assaults (including an estimated two thirds of prostitutes) a) A month after the 9/11 terriosit attacks, a survey of Manhattan residents indicated that 8.5% were suffering PTSD, most as a result of the attack b) Among those living near the World Trade Center, 20% reported such telltale signs as nightmares, severe anxiety, and fear of public places c) To pin down the frequency of this disorder, the US Centers of Disease Control compared 7000 Vietnam combat veterans with 7000 non combat veterans who served during the same years d) On average, according to a reanalysis, 19% of all Vietnam veterans reported PTSD symptoms e) The rate varied from 10% among those who had never seen combat to 32% among those who had experienced heavy combat f) Similar variations in rates have been found among more recent combat veterans and among people who have experienced a natural disaster or have been kidnapped, help captive, tortured, or raped g) The toll seems at least as high for veterans of the Iraq war, where 1 in 6 US combat infantry personnel has reported symptoms of PTSD, depression, or severe anxiety in the months after returning home h) In one study of 103,788 veterans returning from Iraq and Afghanistan, 1 in 4 was diagnosed with a psychological disorder, most frequently PTSD

What is schizophrenia?

1. Nearly 1 in 100 people (about 60% men) develop schizophrenia, with an estimated 24 million across the world suffering from this dreaded disorder 2. Literally translated, SCHIZOPHRENIA means "split mind" a) Schizophrenia: a psychological disorder characterized by delusions, hallucinations, disorganized speech, and/or diminished or inappropriate emotional expression b) It refers not to a multiple personality split but rather to a split from reality that shows itself in disturbed perceptions, disorganized thinking and speech, and diminished, inappropriate emotions c) As such, it is the chief example of a PSYCHOSIS, d) Psychosis: a psychological disorder in which a person loses contact with reality, experiencing irrational ideas and distorted perceptions 3. Symptoms of Schizophrenia a) Highly disordered thought b) Split from reality (psychotic) c) Typically diagnosed in early adulthood d) High suicide rate e) A person with schizophrenia may have HALLUCINATIONS f) Disorganized thoughts may result from a breakdown in SELECTIVE ATTENTION 4. We normally have a remarkable capacity for giving our undivided attention to one set of sensory stimuli while filtering out others a) Those with schizophrenia cannot do this b) Thus, irrelevant, minute stimuli, such as the grooves on a brick or the inflections of a voice, may distract their attention from a bigger event or a speaker's meaning c) As one former patient recalled "What had happened to me was a breakdown in the filter, and a hodgepodge of unrelated stimuli were distracting me from things which should have had my undivided attention d) This selective attention difficulty is but one of dozens of cognitive differences associated with schizophrenia 5. Schizophrenia typically strikes as young people are maturing into adulthood a) Although it only affects 1 in 100 people, it knows no national boundaries, and it affects both males and females though men tend to be stuck earlier, more severely, and slightly more often b) For some, schizophrenia will appear suddenly, seemingly as a reaction to stress c) For others, schizophrenia develops gradually, emerging from a long history of social inadequacy and poor school performance d) No wonder those predisposed to schizophrenia often end up in the lower socioeconomic levels or even homeless 6. When schizophrenia is a slow developing process (called chronic or process, schizophrenia) recovery is doubtful a) Those with chronic schizophrenia often exhibit the persistent and incapacitating negative symptom of social withdrawal b) Men, whose schizophrenia develops on average four years earlier than women's, more often exhibit negative symptoms and chronic schizophrenia c) When previously well adjusted people develop schizophrenia rapidly (called acute or reactive schizophrenia) following particular life stresses, recovery is much more likely d) They more often have the positive symptoms that are responsive to drug therapy e) As you can imagine, such disorganized thinking, disturbed perceptions, and inappropriate emotions profoundly disrupt social relationships and make it difficult to hold a job f) Even those with DISSOCIATIVE IDENTITY DISORDER may continue to function in everyday life, but less so those with schizophrenia g) During their most severe periods, those with schizophrenia live in a private inner world, preoccupied with illogical ideas and unreal images h) Given a supportive environment and medication, ver 40% of schizophrenia patients will have periods of a year or more of normal life experience i) Many others remain socially withdrawn and isolated or rejected throughout much of their lives

what were the ancient treatments for psychological disorders?

1. Ancient Treatments of psychological disorders include trephination, exorcism, being caged like animals, being beaten, burned, castrated, mutilated, or transfused with animal's blood a) To explain puzzling behavior, people in earlier times often presumed the work of strange forces-the movement of the stars, godlike powers, or evil spirits b) Had you lived during the Middle Ages, you might have said, "the devil made him do it," and you might have approved of a cure to rid the evil force by exorcising the demon c) Until the last two centuries, "mad" people were sometimes caged in zoo like conditions or given "therapies" appropriate to a demon: beatings, burning, or castration d) In other times, therapy included pulling teeth, removing lengths of intestines, cauterizing the clitoris, or giving transfusions of animal blood 2. Bedlam-Bethlem Royal Hospital a) "But is there so great Merit and Dexterity in being a mad Doctor? The common Prescriptions of a Bethlemitical Doctor are a purge and a vomit, and a vomit and a purge over again, and sometimes a bleeding, which is no great mystery." b) They believed that there were multiple kinds of blood that needed to remain in balance in your body. If you were sick, they would make you bleed, purge, have diarrhea, and vomit to get rid of the excess blood

what is the biopsychosocial approach for psychological disorders?

1. Assumes that biological, socio-cultural, and psychological factors combine and interact to produce psychological disorders a) Today's psychologists contend that all behavior, whether called normal or disordered, arises from the interaction of nature (genetic and psychological factors) and nurture (past and present experiences) b) To presume that a person is mentally ill, they say, attributes the condition to a sickness that must be identified and cured c) But difficulty in the person's environment, the person's current interpretations of events, or the person's bad habits and poor social skills may also be factors 2. Evidence of such effects comes rom links between specific disorders and cultures a) Cultures differ in their sources of stress, and they produce different ways of coping b) The eating disorders anorexia nervosa and bulimia nervosa, for example, have occurred mostly in Western cultures c) In Malaysia, amok describes a sudden outburst of violent behavior (thus the phrase "run amok") Latin America lays claim to susto, a condition marked by severe anxiety, restlessness, and a fear of black magic Taijin-kyofusho, social anxiety about one's appearance combined with a readiness to blush and a fear of eye contact, appears in Japan, as does the extreme withdrawal of hikikomori d) Such disorders may share an underlying dynamic (such as anxiety) while differing in the symptoms (an eating problem or a type of fear) manifested in a particular culture e) But not all disorders are culture bound f) Depression and schizophrenia occur worldwide g) From Asia to Africa and across the Americas, schizophrenia's symptoms often include irrationality and incoherent speech 3. To asses the whole set of influences-genetic predispositions and physiological states, inner psychological dynamics, and social and cultural circumstances-the biopsychosocial model helps a) This approach recognizes that mind and body are inseparable b) Negative emotions contribute to physical illness, and physical abnormalities contribute to negative emotions c) We are mind embodied and socially embedded The biopsychosocial approach to psychological disorders 1. Biological influences: a) Evolution b) Individual genes c) Brain structure and chemistry 2. Psychological influences: a) Stress b) Trauma c) Learned helplessness d) Mood-related perceptions and memories 3. Social-cultural influences a) Roles b) Expectations c) Definitions of normality and disorders

what is borderline personality disorder?

1. Borderline personality disorder 2. Diagnosis and Symptoms a) Instability in interpersonal relationships and self image b) Impulsive, insecure, unstable, and extreme emotions 3. Etiology a) Genetic b) Childhood abuse

what are personality disorders? What are the types of disorders?

1. Chronic maladaptive cognitive- behavioral patterns a) Some dysfunctional behavior patterns impair people's social functioning without depressive or delusions 2. Among them are PERSONALITY DISORDERS: psychological disorders characterized by inflexible and enduring behavior patterns that impair social functioning a) Anxiety is a feature of one cluster of these disorders, such as a fearful sensitivity to rejection that predisposes the withdrawn AVOIDANT PERSONALITY DISORDER b) A second cluster expresses eccentric or odd behaviors, such as the emotionless disengagement of the SCHIZOID PERSONALITY DISORDER c) A third cluster exhibits dramatic or impulsive behaviors such as the attention getting HISTRIONIC PERSONALITY DISORDER and the self focused and self inflating NARCISSISTIC PERSONALITY DISORDER

what is the dangers of labels? Why are they important?

1. Critics of the DSM-5 argue that labels may stigmatized individuals a) Labels can create preconceptions and stigmatization, but it also allows for doctors to communicate with one another efficiently and effectively b) The DSM has other critics who register a more fundamental complaint-that these labels are at best arbitrary and at worst value judgements masquerading as science c) Once we label a person, we view that person differently d) Labels create preconceptions that guide our perceptions and our interpretations 2. We now diagnose as mental disorder attentional and behavioral problems that used to be seen as part of life and of normal individual variation. The most convincing evidence of this comes from a large study with a particularly disturbing finding. A child's date of birth was a very powerful predictor of whether or not he would get the diagnosis of ADHD. Boys born in January were at 70% higher risk than those born in December simply because January 1 was the cutoff for grade assignment. The youngest, least developmentally mature kids in the class are much more likely to get the diagnosis. 3. Labels may be helpful to communicate disorders with each other a) "Insanity" labels raise moral and ethical questions about how society should treat people who have disorders and have committed crimes 4. In a now classic study of the biasing power of labels, David Rosenhan and seven others went to hospital admissions offices, complains of hearing voices saying empty, hollow, and thud a) Apart from this complain and giving false names and occupations, they answered questions truthfully b) All eight normal people were misdiagnosed with disorders c) As one psychiatrist noted, if someone swallows blood, goes to an emergency room and spits it up, should we fault the doctor for diagnosing a bleeding ulcer d) Surely not e) But what followed the diagnosis in the Rosenhan study was startling f) Until being released an average o 19 days later, the patients exhibited no further symptoms such as hearing voices g) Yet after analyzing their (quite normal) life histories, clinicians were able to discover the causes of their disorders, such as reacting with mixed emotions about a parent h) Even the routine behavior of taking notes was misinterpreted as a symptom i) Labels matter j) When people in another experiment watched videotaped interviews, those told the interviewees were job applicants perceived them as normal k) Those who thought they were watching psychiatric or cancer patients perceived them as different from most people l) Therapists who thought an interviewee was a psychiatric patient perceived him as frightened of his own aggressive impulses, a passive dependent type, and so forth m) A label can, as Rosenhan discovered have a life and an influence of its own 5. Surveys in Europe and North American has demonstrated the stigmatizing power of labels a) Getting a job or finding a place to rent can be a challenge for those known to be just released from prison-or a mental hospital b) But as we are coming to understand that many psychological disorders are diseases of the brain, not failures of character, the stigma seems to be lifting c) Public figures are feeling freer to come out and speak with candor about their struggles with disorders such as depression d) And the more contact people have with individuals with disorders, the more accepting their attitudes are e) People express deepest sympathy for people whose disorders are gender atypical-for men suffering depression (which is more common among women,) or for women plagued by alcohol use disorder 6. Nevertheless, stereotypes linger in media portrayals of psychological disorders a) Some are reasonably accurate and sympathetic b) But too often people with disorders are portrayed as objects of humor or ridicule as homicidal maniacs or as freaks c) Apart from the few who experience threatening delusions and hallucinated voices that command a violent act, and from those whose dysfunctionality includes substance abuse, mental disorders seldom lead to violence d) In real life, people with disorders are more likely to be the victims of violence than the perpetrators e) Indeed, reported the US Surgeon General's office, there is very little risk of violence or harm to a stranger from casual contact with an individual who has a mental disorder f) Although most people with psychological disorders are not violent, those who are create a moral dilemma for society g) Not only can labels bias perceptions, they can also change reality h) When teachers are told certain students are gifted, when students expect someone to be hostile or when interviewers check to see whether someone is extraverted, they may act in ways that elicit the very behavior expected i) Someone who was led to think you are nasty may treat you coldly, leading you to respond as a mean spirited person would j) Labels can serve as self fulfilling prophecies 7. But let us remember the benefits of diagnostic labels a) Mental health professionals use labels to communicate about their cases, to comprehend the underlying causes, and to discern effective treatment programs b) Diagnostic definitions also inform patient self understandings c) And they are useful in research that explores the causes and treatments of disordered behavior

what are the causes of eating disorders?

1. Eating disorders do not provide (as some have speculated) a telltale sign of childhood sexual abuse a) The family environment may provide a fertile ground for the growth of eating disorders in other ways, however: b) Mothers of girls with eating disorders tend to focus on their own weight and on their daughters' weight and appearance c) Families of bulimia patients have a higher than usual incidence of childhood obesity and negative self evaluation d) Families of anorexia patients tend to be competitive, high achieving, and protective 2. Those with eating disorders often have low self evolutions, set perfectionist standards, fret about falling short of expectations, and are intensely concerned with how others perceive them a) Some of these factors also predict teen boys' pursuit of unrealistic muscularity 3. Genetics also influence susceptibility to eating disorders a) Twins are more likely to share the disorder if they are identical rather than fraternal b) Scientists are now searching for culprit genes, which may influence the body's available serotonin and estrogen 4. But these disorders also have cultural and gender components a) Ideal shape vary across culture and time b) In impoverished areas of the world, including much of Africa-where plumpness means prosperity and thinness can signal poverty or illness-bigger seems better c) Bigger does not seem better in Western cultures, where, according to 222 studies of 141,00 people, the rise in eating disorders over the last 50 years has coincides with a dramatic increase in women having a poor body image d) Those must vulnerable to eating disorders are also those (usual women or gay men) who most idealize thinness, and have the greatest body dissatisfaction e) Should it surprise us, then, that when women view real and doctored images of unnaturally thin models and celebrities, they often feel ashamed, depressed, and dissatisfied with their own bodies-the very attitudes that predispose eating disorders f) Researchers tested this modeling idea by giving some adolescent girls (but not others) a 15 month subscription to an American teen fashion magazine g) Compared with their counterparts who had not received the magazine, vulnerable girls defined as those who were already dissatisfied idealizing thinness, and lacking social support-exhibited increased body dissatisfaction and eating disorder tendencies h) But even ultra-thin models do not reflect the impossible standard of the classic Barbie doll, who had, when adjusted to a height of 5 feet 7 inches, a 32-16-29 figure i) It seems clear that the sickness of today's eating disorders lies in part within our weight obsessed culture-a culture that says in countless ways, "fat is bad," that motivates millions of women to be "always dieting," and that encourages eating binges by pressuring women to live in a constant state of semistarvation j) If cultural learning contributes to eating behavior, then might prevention programs increase acceptance of one's body? k) Reviews of prevention studies answer yes and especially if the programs are interactive and focused on girls over age 15

What causes schizophrenia?

1. Etiology of Schizophrenia a) Schizophrenia is not only the most dreaded psychological disorder but also one of the most heavily researched b) Most of the new research studies link it with brain abnormalities and genetic predispositions c) Schizophrenia is a disease of the brain manifest in symptoms of them ind 1. Biological factors a) genetic predispositions b) structural brain abnormalities c) regulation of neurotransmitters 2. Psychological factors a) Vulnerability stress hypothesis 3. Sociocultural factors a) Influence how disorder progresses

what are some controversies surrounding DSM-5?

1. Expansion of diagnosable disorders: net result of diagnostic inflation maybe a greatly expand the numbers of people labeled as suffering from a mental disorder or mental illness. Mild Neurocognitive Disorder may pathologize mild cognitive changes or everyday forgetting in older adults. Disruptive Mood a) Dysregulation Disorder may pathologize repeated tantrums in children b) Changes in classification of mental disorders: Critics question whether in classification are justified and might lead to greater diagnostic confusion; parents of Asperger's children are concerned their children may not qualify for the new ASD diagnosis and associated treatment benefits. c) Medical research has made such enormous advances that there are hardly any healthy people left. d) Fluctuations in diagnostic rates follow a time course much more consonant with fashion than with toxin

What are anxiety disorders?

1. Feelings of excessive apprehension and anxiety Anxiety is part of life. a) Speaking in front of a class, peering down from a ladder, or waiting to play in a big game, any one of us might feel anxious b) At times we may feel enough anxiety to avoid making eye contact or talking with someone- "shyness" we call it c) Fortunately for most of us, our uneasiness is not intense and persistent d) Some of us, however are more prone to notice and remember threats e) This tendency may place us at risk for one of the ANXIETY DISORDERS, marked by distressing, persistent anxiety or dysfunctional anxiety-reducing behaviors 2. Anxiety disorders: psychological disorders characterized by distressing, persistent anxiety or maladaptive behaviors that reduce anxiety 3 We will consider these three anxiety disorders: a) Generalized anxiety disorder in which a person is unexplainably and continually tense and uneasy b) Panic Disorder in which a person experiences sudden episodes of intense dread c) Phobias in which a person is intensely and irrationally afraid of a specific object of situation d) Obsessive-compulsive disorder, in which a person is troubled by repetitive thoughts or actions A) Involves anxiety but it no longer classified as an anxiety disorder in DSM-5 e) Post traumatic stress disorder, in which a person has lingering memories, nightmares, and other symptoms for weeks after a severely threatening, uncontrollable event A) Involves anxiety but it no longer classified as an anxiety disorder in DSM-5

What are the two explanations for anxiety disorders?

1. Freud suggested that we repress our painful and intolerable ideas, feelings, and thoughts, resulting in anxiety a) This does not hold much clout anymore 2. Anxiety is both a feeling and a cognition, a doubt laden appraisal of one's safety or social skill a) How do these anxious feelings and cognitions arise? b) Freud's psychoanalytic theory proposed that, beginning in childhood, people repress intolerable impulses, ideas, and feelings and that this submerged mental energy sometimes produces mystifying symptoms, such as anxiety c) Today's psychologists have instead turned to two contemporary perspectives-learning and biological 3. There are 2 main perspectives, Learning and Biological

how do genes influence the prevalence of mood disorders?

1. Genetic influences: mood disorders have a genetic component a) Mood disorders run in families b) As one researcher noted, emotions are postcards from our genes c) The risk of major depression and bipolar disorder increases if you have a parent or sibling with the disorder 2. If one identical twin is diagnosed with major depressive disorder, the chances are about 1 in 2 that at some time the other twin will be, too. a) If one identical twin has bipolar disorder, the chances are 7 in 10 that the other twin will at some point be diagnosed similarly b) Among fraternal twins, the corresponding odds are just under 2 in 10 c) The greater similarity among identical twins holds even among twins raised apart d) Summarizing the major twin studies, one research team estimated the heritability (extend to which individual differences are attributable to genes) of major depression at 37% e) Moreover, adopted people who suffer a mood disorder often have close biological relatives who suffer mood disorders, develop alcohol use disorder, or commit suicide 3. To tease out the genes that put people at risk for depression, some researchers have turned to LINKAGE ANALYSIS a) After finding families in which the disorder appears across several generations, geneticists examine DNA from affected and unaffected family members, looking for differences b) Linkage analysis points us to a chromosome neighborhood note behavior genetics researchers Robert Plomin and Peter McGuffin; a house to house search is then needed to find the culprit gene c) Such studies are reinforcing the view that depression is a complex conditions d) Many genes work together, producing a mosaic of small effects that interact with other factors to put some people at greater risk e) If the culprit gene variations can be identified-with chromosome 3 genes implicated in separate British and American studies-they may open the door to more effective drug therapy

What are the facts that every researcher teams agree on for mood disorders?

1. In thousands of studies, psychologists have been accumulating evidence to help explain mood disorders and suggest more effective ways to treat and prevent them 2. Researcher Peter Lewinsohn and his colleagues summarized the facts that any theory of depression must explain, including the following a) MANY BEHAVIORAL AND COGNITIVE CHANGES ACCOMPANY DEPRESSION: people trapped in a depressed mood are inactive and feel unmotivated they are sensitive to negative happenings. They more often recall negative information. They expect negative outcomes. When the mood lifts, those behavioral and cognitive accompaniments disappear. Nearly half the time, people also exhibit symptoms of another disorder such as anxiety or substance use disorder b) DEPRESSION IS WIDESPREAD: it is commonality suggests that its causes, too must be common c) WOMEN'S RISK OF MAJOR DEPRESSION IS NEARLY DOUBLE MEN'S: when Gallup in 2009 asked more than a quarter million Americans if they had ever been diagnosed with depression, 13% of men and 22% of women said they had. This gender gap has been found worldwide. The trend begins in adolescence; preadolescent girls are not more depression-prone than are boys. The factors that put women at risk for depression (genetic predispositions, child abuse, low self esteem, marital problems, and so forth) similarly put men at risk. Yet women are more vulnerable to disorders involving internalized states, such as depression, anxiety, and inhibited sexual desire. Men's disorders tend to be more external-alcohol use disorder, antisocial conduct, lack of impulse control. When women get sad, they often get sadder than men do. When men get mad, they often get madder than women do. d) MOST MAJOR DEPRESSIVE EPISODES SELF TERMINATE: although therapy often helps and tends to speed recovery, most people suffering major depression eventually return to normal even without professional help. The plague of depression comes and, a few weeks or months later, it goes, though for about half of people it eventually recurs. For only about 20% is the condition chronic. On average, patients with major depression today will spend about three fourths of the next decade in a normal, nondepressed state. Recovery is more likely to be permanent the later the first episode strikes, the longer the person stays well, the fewer the previous episodes the less stress experienced, and the more social support received e) STRESSFUL EVENTS RELATED TO WORK, MARRIAGE AND CLOSE RELATIONSHIPS OFTEN PRECEDE DEPRESSION: A family member's death, a job loss, a marital crisis, or a physical assault increase one's risk of depression. If stress related anxiety is a crackling menacing brushfire notes biologist Robert Sapolsky, depression is a suffocating heavy blanket thrown on top of it. One long term study tracked rates of depression in 2000 people. The risk of depression ranged from less than 1 percent among those who had experienced no stressful life event in the preceding month to 24% among those who had experienced three such events in that month f) WITH EACH NEW GENERATION, DEPRESSION IS STRIKING EARLIER (NOW OFTEN IN THE LATE TEENS) AND AFFECTING MORE PEOPLE, WITH THE HIGHEST RATES IN DEVELOPED COUNTRIES AMONG YOUNG ADULTS: This is true in Canada, the United States, England, France, Germany, Italy, Lebanon, New Zealand, Puerto Rico, and Taiwan. In one study, 12% of Australian adolescents reported symptoms of depression. Most hid it from their parents; almost 90% of those parents perceived their depressed teens as not suffering depression. In North America, today's young adults are three times more likely than their grandparents to report having recently-or ever-suffered depression (despite the grandparents' many more years of being at risk). The increase appears partly authentic, but it may also reflect today's young adults' greater willingness to disclose depression g) Today's researchers propose biological and cognitive explanations of depression, often combined in a biopsychosocial approach

what is the learning perspective of anxiety disorders?

1. Learning theorists (Bandura) suggest that fear conditioning leads to anxiety 2. Classical and Operant conditioning a) When bad events happen unpredictably and uncontrollably, anxiety or other disorders often develop b) Using classical conditioning, researchers have also created chronically anxious, ulcer prone rats by giving them unpredictable electric shocks c) Like assault victims who report feeling anxious when returning to the scene of the crime, the rats become apprehensive in their lab environment d) This link between conditioned fear and general anxiety helps explain why anxious or traumatized people are hyperattentive to possible threats, and how panic prone people come to associate anxiety with certain cues e) In one survey, 58% of those with social anxiety disorder experienced their disorder after a traumatic event f) Through conditioning the short list of naturally painful and frightening events can multiply into a long list of human fears g) Marilyn's phobia of thunderstorms may have been similarly conditioned during a terrifying or painful experience associated with a thunderstorm 3. When anxiety then becomes associated with other objects or events (stimulus generalization) and is reinforced a) Two specific learning processes can contribute to these disorders b) The first STIMULUS GENERALIZATION, occurs, for example, when a person attacked by a fierce dog later develops a fear of all dogs c) The second learning process, REINFORCEMENT, helps maintain our phobias and compulsions after they arise d) Avoiding or escaping the feared situation reduces anxiety, thus reinforcing the phobic behavior e) Feeling anxious or fearing a panic attack, a person any go inside and be reinforced by feeling calmer f) Compulsive behaviors operate similarly g) If washing your hands revelieves your feelings of anxiety, you may wash your hands again when those feelings return 4. Fear responses may be initiated through OBSERVATIONAL LEARNING a) Young monkeys develop fear when they watch other monkeys who are afraid of snakes b) One way to develop phobias is to watch people who have the phobias react to it c) We may also learn fear through observational learning-by observing others' fear. d) Susan Mineka sought to explain why nearly all monkeys reared in the wild fear snakes, yet lab reared monkeys do not e) Surely most wild monkeys do not actually suffer snake bites f) Do they learn their fear through observation? g) To find out, Mineka experimented with six monkeys reared in the wild (all strongly fearful of snakes) and their lab-reared offspring (virtually none of which feared snakes) h) After repeatedly observing their parents or peers refusing to reach for foo in the presence of a snake, the younger monkeys developed a similar strong fear of snakes i) When retested three months later, their learned fear persisted k) Humans likewise learn fears by observing others 5. Cognition a) Observational learning is not the only cognitive influence on feelings of anxiety b) Our interpretations and irrational beliefs can also cause feelings of anxiety c) Whether we interpret the creaky sounds in the old house simply as the wind or as a possible knife wielding intruder determines whether we panic d) People with anxiety disorder also tend to be HYPER VIGILANT e) A pounding heart becomes a sign of a heart attack f) A lone spider near the bed becomes a likely infestation g) An everyday disagreement with a friend or boss spells possible doom for the relationship h) Anxiety is especially common when people cannot switch off such intrusive thoughts and perceive a loss of control and sense of helplessness

How does a virus while a mother is pregnant cause schizophrenia?

1. Maternal virus during mid pregnancy a) Consider another possible culprit: a mid pregnancy viral infection that impairs fetal brain development 2. Scientists have asked the following: a) Are people at increased risk of schizophrenia if during the middle of their fetal development their country experienced a flu epidemic: the repeated answer is yes b) Are people born in densely populated areas, where viral diseases spread more readily, at greater risk for schizophrenia: the answer, confirmed in a study of 1.75 million Danes, is Yes c) Are those born during the winter and spring months after the fall-winter flu season also at increased risk: although the increase is small just 5 to 8% the answer is again yes d) In the southern hemisphere, where the seasons are the reverse of the northern hemisphere, are the months of above average schizophrenia births similarly reversed: again, the answer is yes, though somewhat less so. In Australia, for example, people born between August and October are at greater risk-unless they migrated from the Northern Hemisphere, in which case their risk is greater if they were born between January and March e) Are mothers who report being sick with influenza during pregnancy more likely to beat children who develop schizophrenia: in one study of nearly 8000 women, the answer was yes. The schizophrenia risk increased from the customary 1% to about 2% but only when infections occurred during the second trimester. Maternal influenza infection during pregnancy also affects brain development in monkeys f) Does blood drawn from pregnant women whose offspring develop schizophrenia show higher than normal levels of antibodies that suggest a viral infection: in one study of 27 women whose children later developed schizophrenia, the answer was yes. And the answer was again yes in a huge California study which collected blood samples from some 20,000 pregnant women during the 1950s and 1960s. Another study found traces of a specific retrovirus 9HERV) in nearly half of people with schizophrenia and virtually none in healthy people 3. These converging lines of evidence suggest that fetal virus infections play a contributing role in the development of schizophrenia a) They also strengthen the recommendation that women who will be more than three months pregnant during the flu season have a flu shot b) Why might a second trimester maternal flu put fetuses at risk? Is it the virus itself? The mother's immune response to it? Medications taken? Does the infection weaken the brain's supportive glial cells, leading to reduced synaptic connections? c) In time, answers may become available

How do structural brain abnormalities and neurotransmitters cause schizophrenia?

1. Might imbalances in brain chemistry underlie schizophrenia? a) Scientists have long known that strange behavior can have strange chemical causes b) The saying "mad as a hatter" refers to the psychological deterioration of British hatmakers whose brains, it was later discovered, were slowly poisoned as they moistened the brims of mercury laden felt hats with their tongue and lips c) Scientists are clarifying the mechanism by which chemicals such as LSD produce hallucinations d) These discoveries hint that schizophrenia symptoms might have a biochemical key 2. Dopamine overactivity a) Researchers discovered one such key when they examined schizophrenia patients' brains after death and found an excess of receptors for dopamine-a sixfold excess for the so called D4 dopamine receptor b) They not speculate that such a hyper-responsive dopamine system may intensify brain signals in schizophrenia, creating positive symptoms such as hallucinations and paranoia c) As we might therefore expect, drugs that block dopamine receptors often lessen these symptoms; drugs that increase dopamine levels, such as amphetamines and cocaine, sometimes intensify them 3. Abnormal brain activity and anatomy a) Modern brain scanning techniques reveal that many people with chronic schizophrenia have abnormal activity in multiple brain areas b) Some have abnormally low brain activity in the frontal lobes, which are critical for reasoning, planning, and problem solving c) People diagnosed with schizophrenia also display a noticeable decline in the brain waves that reflect synchronized neural firing in the frontal lobes d) Out of sync neurons may disrupt the integrated functioning of neural networks, possibly contributing to schizophrenia symptoms e) One study took PET scans of brain activity while people were hallucinating f) When participants heard a voice or saw something, their brain became vigorously active in several core regions, including the thalamus, a structure deep in the brain that filters incoming sensory signals and transmits them to the cortex g) Another PET scan study of people with paranoia found increased activity in the amygdala, a fear processing center 4. Many studies have found enlarged fluid filled areas and a corresponding shrinkage and thinning of cerebral tissue in people with schizophrenia a) Some studies have even found such abnormalities in the brains of people who would later develop this disorder and in their close relatives b) One smaller than normal area is the cortex c) Another is the corpus callosum connection between the two hemispheres d) Another is the thalamus, which may explain why people with schizophrenia have difficulty filtering sensory input and focusing attention 4. The bottom line of various studies is that schizophrenia involves not one isolated brain abnormality but problems with several brain regions and their interconnections a) Naturally, scientists wonder what causes these abnormalities b) Some point to mishaps during prenatal development or delivery c) Risk factors for schizophrenia include low birth weight, maternal diabetes, older paternal age, and oxygen deprivation during delivery d) Famine may also increase risk e) People conceived during the peak of the Dutch wartime famine later displayed a doubled rate of schizophrenia, as did those conceived during the famine that occurred from 1959 to 1961 in eastern China

what is the etiology of dissociative identity disorder?

1. Mostly women 2. Extraordinarily severe abuse in early childhood a) Researchers and clinicians have interpreted DID symptoms from psychodynamic and learning perspectives b) Both views agree that the symptoms are ways of dealing with anxiety c) Psychodynamic theorists see them as defense against the anxiety caused by the eruption of unacceptable impulses; a wanton second personality enables the discharge of forbidden impulses d) Learning theorists see dissociative disorders as behaviors reinforced by anxiety reduction e) Other clinicians include dissociative disorders under the umbrella of posttraumatic stress disorder-a natural protective response to histories of childhood trauma f) Many DID patients recall suffering physical, sexual, or emotional abuse as children g) In one study of 12 murderers diagnosed with DID, 11 had suffered severe, torturous child abuse h) One was set afire by his parents, another was used in child pornograph and was scarred from being made to sit on a stove burner i) Some critics wonder, however, whether vivid imagination or therapist suggestion contributes to such recollections 3. Social contagion (diagnosis peaks when in media)

what are the types of eating disorders?

1. Our bodies are naturally disposed to maintain a steady weight, including stored energy reserves for times when food becomes unavailable a) Yet sometimes psychological influences overwhelm biological wisdom This becomes painfully clear in three eating disorders 2. ANOREXIA NERVOSA typically begins as a weight loss diet a) Anorexia nervosa: an eating disorder in which a person (usually an adolescent female) maintains a starvation diet despite being significantly (15% or more) underweight b) People with anorexia-usually adolescents and 9 times out of 10 females-drop significantly below normal weight c) Yet they feel fat, fear being fat, and remain obsessed with losing weight, and sometimes exercise excessively d) About half of those with anorexia display a binge purge depression cycle 3. BULIMIA NERVOSA may also be triggered by a weight loss diet, broken by gorging on forbidden foods a) Bulimia nervosa: an eating disorder in which a person alternates binge eating (usually of high calorie foods) with purging (by vomiting or laxative use) excessive exercise, or fasting b) Binge purge eaters-mostly women in their late teens or early twenties-eat in spurts, sometimes influenced by friends who are bingeing c) In a cycle of repeating episodes, overeating is followed by compensatory purging (through vomiting or laxative use), fasting, or excessive exercise d) Preoccupied with food (craving sweet and high fat foods) and fearful of becoming overweight, binge purge eaters experience bouts of depression and anxiety during and following binges e) Unlike anorexia, bulimia is marked by weight fluctuations within or above normal ranges, making the condition easy to hide 4. Those who do significant binge eating, followed by remorse-but do not purge, fast, or exercise excessively-are said to have BINGE EATING DISORDER a) Binge eating disorder: significantly binge eating episodes, followed by distress, disgust, or guilt, but without the compensatory purging or fasting that marks bulimia nervosa 5. A national study funded by the US National Institute of Mental Health reported that at some point during their lifetime, 0.6% of people meet the criteria for anorexia, 1 percent for bulimia, and 2.8 percent for binge eating disorder

what is the medical model? Who created it?

1. Philippe Pinel (1745-1826) from France, insisted that madness was not due to demonic possession, but an ailment of the mind a) Treat people with kindness and not treating them like zoo animals b) In opposition to brutal treatments, reformers, including Phillippe Pinel in France, insisted that madness is not demon possession but a sickness of the mind caused by severe stresses and inhumane conditions c) For Pinel and others "moral treatment" included boosting patient's morale by unchaining them and talking with them and by replacing brutality with gentleness, isolation with activity, and filth with clean air and sunshine d) While such measures did not often cure patients, they were certainly more humane 2. By the 1800s, the discovery that syphilis infects the brain and distorts the mind drove further gradual reform a) Hospital replaced asylums, and the medical world began searching for physical causes and treatments of mental disorders b) Today, this MEDICAL MODEL is recognizable in the terminology of the mental health movement: a mental illness (also called a psychopathology) needs to be diagnosed on the basis of its symptoms and treated through therapy which may include time in a psychiatric hospital 3. MEDICAL MODEL: the concept that diseases, in this case psychological disorders, have physical causes that can be diagnosed, treated, and in most cases, cared, often through treatment in a hospital a) The medical perspective has gained credibility from recent discoveries that genetically influenced abnormalities in brain structure and biochemistry contribute to many disorders b) But as we will see, psychological factors, such as chronic or traumatic stress, also play an important role 4. When physicians discovered that syphilis led to mental disorders, they started using medical models to review the physical causes of these disorders: a) Etiology: Cause and development of the disorder b) Diagnosis: identifying (symptoms) and distinguishing one disease from another Different steps that need to be taken before a diagnosis c) Treatment: treating a disorder in a psychiatric hospital Hospitals used to have a psychiatric ward but now there is just one in the county d) Prognosis: forecast about the disorder

What are the positive, negative, and cognitive symptoms of schizophrenia?

1. Positive symptoms a) Hallucinations and delusions A) Hallucinations: false sensory experience, such as seeing something in the absence of an external visual stimulus B) They may see, feel, taste, or smell things that are not there C) Most often however, the hallucinations are auditory, frequently voices making insulting remarks or giving orders D) The voices may tell the patient that she is bad or that she must burn herself with a cigarette lighter E) Imagine your own reaction if a dream broke into your waking consciousness F) When the unreal seems real, the resulting perceptions are at best bizarre, at worst terrifying G) Disorganized thinking and disturbed perceptions H) The thinking of a person with schizophrenia is fragments, bizarre, and often distorted by false beliefs called DELUSIONS I) Delusions: false beliefs, often of persecution or grandeur, that may accompany psychotic disorders J) Those with paranoid tendencies are particularly prone to delusions of persecution K) Even with sentences, jumbled ideas may create what is called WORD SALAD L) One young man begged for a little more allegro in the treatment and suggested that libationary movement with a view to the widening of the horizon will ergo extort some wit in lectures b) Thought disorders c) Disorders of movement 2. Negative symptoms a) Flat affect A) Diminished and inappropriate emotions B) The expressed emotions of schizophrenia are often utterly inappropriate, split off from reality C) One woman laughed after recalling her grandmother's death, cried when others laughed, or became angry for no apparent reason D) Others with schizophrenia lapse into an emotionless state of FLAT AFFECT E) Most also have difficulty perceiving facial emotions and reading others' states of mind F) ) Motor behavior may also be inappropriate G) Some perform senseless, compulsive acts, such as continually rocking or rubbing an arm b) Others, who exhibit CATATONIA, may remain motionless for hours and then become agitated 3. Cognitive symptoms a) Attention difficulties and memory problems b) Impaired ability to interpret information and make decisions 4. We have thus far described schizophrenia as if it were a single disorder a) Actually it varies b) Schizophrenia patients with POSITIVE SYMPTOMS may experience hallucinations, talk in disorganized and deluded ways, and exhibit inappropriate laughter, tears, or rage c) Those with NEGATIVE SYMPTOMS have toneless voices, expressionless faces, or mute and rigid bodies d) Thus POSITIVE SYMPTOMS ARETHE PRESENCE OF INAPPROPRIATE BEHAVIORS AND NEGATIVE SYMPTOMS ARE THE ABSENCE OF APPROPRIATE BEHAVIORS

So what determines whether a person suffers PTSD after a traumatic event?

1. Research indicates that the greater one's emotional distress during a trauma, the higher the risk for posttraumatic symptoms a) Among NEw Yorkers who witnessed the 9/11 attacks, PTSD was doubled for survivors who were inside rather than outside the World Trade Center b) And them more frequent an assault experience, the more adverse the long term outcomes tend to be c) In the 30 years after the Vietnam war, veterans who came home with a PTSD diagnosis had twice the normal likelihood of dying 2. A sensitive limbic system seems to increase vulnerability, by flooding the body with stress hormones again and again as images of the traumatic experience erupt into consciousness 3. Brain scans of PTSD patients suffering memory flashbacks reveal an aberrant and persistent right temporal lobe activation 4. Genes may also play a role a) In one study, combat-exposed men had identical twins who did not experience combat b) But these nonexposed co-twins still tended to share their brother's risk for cognitive difficulties, such as unfocused attention c) Such findings suggest that some PTSD symptoms may actually be genetically predisposed 5. Some psychologists believe that PTSD has been overdiagnosed, due partly to a broadening definition of trauma a) PTSD is actually infrequent, say those critics, and well intentioned attempts to have people relive the trauma may exacerbate their emotions and pathologize normal stress reactions b) Debriefing survivors right after a trauma by getting them to revisit the experience and vent emotions has actually proven generally ineffective and sometime harmful c) Researchers have noted the impressive survivor resiliency of those who do not develop PTSD d) About half of adults experience at least one traumatic event in their lifetime, but only about 1 in 10 women and 1 in 20 men develop PTSD e) More than 9 in 10 New Yorkers, although stunned and grief stricken by 9/11 did not respond pathologically f) By the following January, the stress symptoms of the rest had mostly subsided g) Similarly, most combat stressed veterans and most political dissidents who survive dozens of episodes of torture do not later exhibit PTSD h) Likewise, the Holocaust survivors in 71 studies showed remarkable resilience i) Despite some lingering stress symptoms, most experienced essentially normal physical health and cognitive functioning j) Psychologist Peter Suedfeld, who as a boy survived the Holocaust under deprived conditions while his mother died in Auschwitz, has documented the resilience of Holocuast survivors, most of whom have lived productive lives k) It is not always true that "what doesn't kill you makes you stronger," but it is often true he reports. And what doesn't kill you may reveal to you just how strong you really are. 6. Indeed, suffering can lead to benefit finding and to what Richard Tedeschi and Lawrence Calhoun called POSTTRAUMATIC GROWTH a) Posttraumatic growth: positive psychological changes as result of struggling with extremely challenging circumstances and life cries b) Tedeschi and Calhoun have found that the struggle with challenging crises, such as facing cancer, often leads people later to report an increased appreciation for life, more meaningful relationships, increased personal strength, changed priorities, and a richer spiritual life c) This idea-that suffering has transformative power-is also found in Judaism, Christianity, Hindusim, Buddhism, and Islam d) The idea is confirmed by research with ordinary people e) Compared with those with traumatic life histories and with those unchallenged by any significant adversity, people whose life history includes some adversity tend to enjoy better mental health and well being f) Out of even our worst experiences some good can come g) Like the body, the mind has great recuperative powers and may grow stronger with exertion

what are the two sides of debate for the existence of dissociative identity disorder?

1. Skeptics question whether DID is a genuine disorder or an extension of our normal capacity for personality shifts a) Nicholas Spanos asked college students to pretend they were accused murderers being examined by a psychiatrist b) Given the same hypnotic treatment Bianchi received, most spontaneously expressed a second personality c) This discovery made Spanos wonder: are dissociative identities simply a more extreme version of our capacity to vary the "selves" we present-as when we display a goofy, loud self while hanging out with friends, and a subdued, respectful self around grandparents? d) Are clinicians who discovered multiple personalities merely triggering role playing by fantasy prone people? e) Do these patients, like actors who commonly report losing themselves in their roles, then convince themselves of the authenticity of their own role enactments? f) Spanos was no stranger to this line of thinking g) In a related research area, he had also raised these questions about the hypnotic state h) Given that most DID patients are highly hypnotizable, whatever explains one condition-dissociation or role playing may help explain the other 2. Skeptics also find it suspicious that the disorder is so localized in time and space a) Between 1930 and 1960, the number of DID diagnoses in North America was 2 per decade. b) In the 1980s when the DSM contained the first formal code for this disorder, the number of reported cases had exploded to more than 20,000 c) The average number of displayed personalities also mushroomed-from 3 to 12 per patient d) Outside North America, the disorder is much less prevalent, although in other cultures some people are said to be "possessed" by an alien spirit e) In Britain, DID-which some have considered a wacky American fad-is rare f) In India and Japan, it is essentially nonexistent or at least unreported 3. Such findings, skeptics say, point of a cultural phenomenon a disorder created by therapists in a particular social context a) Rather than being provoked by trauma, dissociative symptoms tend to be exhibited by suggestible, fantasy prone people b) Patients do not enter therapy saying "allow me to introduce my selves." c) Rather note these skeptics, some therapists go fishing for multiple personalities: "Have you ever felt like another part of you does things you can't control? Does this part of you have a name? Can I talk to the angry part of you?" d) Once patients permit a therapist to talk, by name, to the part of you that says those angry things, they begin acting out the fantasy e) Like actors who lose themselves in their roles, vulnerable patients may become the parts they are acting out f) The result may be the experience of another self 4. Other researchers and clinicians believe DID is a real disorder a) They find support for this view in the distinct brain and body states associated with differing personalities b) Handedness, for example, sometimes switches with personality c) Ophthalmologists have detected shifting visual acuity and eye muscle balance as patients switched personalities, changes that did not occur among control group members trying to simulate DID d) Dissociative disorder patients also have exhibited heightened activity in brain areas associated with the control and inhibition of traumatic memories 5. So the debate continues a) On one side are those who believe multiple personalities are the desperate efforts of the traumatized to detach from a horrific existence b) One the other are the skeptics who think DID is a condition contrived by fantasy prone, emotionally vulnerable people, and constructed out of the therapist patient interaction c) If the skeptics' view wins, predicted psychiatrist Paul McHugh, this epidemic will end in the way that the witch craze ended in Salem. The multiple personality phenomenon will be seen as manufactured

what are psychological disorders? What does it mean that the disorders are distressful, dysfunctional, deviant?

1. Some psychological disorders come about as a way to cope with other things a) Stressors lead to mental disorders 2. Psychological Disorders are persistently harmful thoughts, feelings, and actions a) When behavior is deviant, distressful, and dysfunctional psychiatrists and psychologists label it as disordered b) Psychological Disorders: a syndrome marked by a clinically significant disturbance in an individual's cognition, emotion regulation, or behavior (adapted from American Psychiatric Association) c) Disturbed, or DYSFUNCTIONAL, behaviors are MALADAPTIVE-they interfere with normal day-to-day life d) An intense fear of spiders may be admiral, but if it doesn't interfere with your life, it is not a disorder e) If occasional sad moods persist and become disabling, they may signal a psychological disorder f) Distress often accompanies dysfunctional behaviors Deviant, Distressful and Dysfunctional 3. Deviant behavior in one culture may be considered normal, while in others it may lead to arrest a) Have to meet certain criteria to be diagnosed with a disorder. The problem is that in the medical community, you are paid by insurance and insurance doesn't pay you unless you have a diagnosis. Doctors are financially incentivised to give you a diagnosis. 4. Over time, definitions of what makes for a significant disturbance have varied a) From 1952 through December 9, 1973, homosexuality was classified as a mental illness b) By day's end on December 10, it was not c) The American Psychiatric Association has dropped homosexuality as a disorder because more and more of its members no longer viewed it as a psychological problem (later research revealed that the stigma and stresses that often accompany homosexuality, however, increase the risk of mental health problems) d) In this new century, controversy swirls over the frequent diagnosing of children with attention deficit hyperactivity disorder (ADHD) 5. Deviant behavior must accompany distress a) Personal or close to you distress has to accompany deviant behavior. You can be harming relationships which causes distress without realizing it 6. If a behavior is dysfunctional it is clearly a disorder a) The culture kinda defines what is considered dysfunctional

what is nonsuicidal self injury? Why do people hurt themselves? Does NSSI lead to suicide?

1. Suicide is not the only way to send a message or deal with distress a) Some people, especially adolescents and young adults, may engage in nonsuicidal self injury (NSS) b) Such behavior includes cutting or burning the skin, hitting oneself, pulling hair out, inserting objects under the nails or skin, and self administering tattooing 2. Why do people hurt themselves? a) Those who do so tend to be less able to tolerate emotions distress, are extremely self critical, and often have poor communication and problem solving skills 3. They engage in NSSI to: a) Gain relief from intense negative thoughts through the distraction of pain b) Ask for help and gain attention c) Relieve guilty by self punishment d) Get others to change their negative behavior (bullying criticism,) e) To fit in with a peer group 4. Does NSSI lead to suicide? a) Usually not b) Those who engage in NSSI are typically suicide gesturers, not suicide attempters c) Suicide gestures engage in NSSI as a desperate but non life threatening form of communication or when they are feeling overwhelmed d) But NSSI has been shown to be a risk factor for future suicide attempts e) If people do not get help, their nonsuicidal behavior may escalated to suicidal ideation and finally to attempt suicide

what is a mood disorder?

1. The emotional extremes of MOOD DISORDERS come in two principal forms a) Major depressive disorder A) Depression is one of the most common. Some type of anxiety disorder and depression often go hand in hand B) MAJOR DEPRESSIVE DISORDER, with its prolonged hopelessness and lethargy b) Bipolar disorder A) Bipolar disorder can manifest as depressive disorder until a mania episode hits later on B) Bipolar disorder: a mood disorder in which episodes of depression and mania (excessive euphoria) occur (formerly called manic depressive disorder), in which a person alternates between depression and mania, an overexcited hyperactive state 2. Mood disorder: psychological disorders characterized by emotional extremes. (major depressive disorder, mania, and bipolar disorder)

What is suicide? What are the statistics on it? What should you do and not do if someone is threatening suicide?

1. The most severe form of behavioral response to depression is suicide. Each year some 1 million people commit suicide worldwide a) Men are more successful at completing suicide than women. Women try to preserve the body, but men don't care. b) The largest age group is white males over 75 then men between the ages of 16-25. c) There is a lot of suicides in America (a lot of single car accidents that we consider accidents but are actually suicides) d) Whites are more likely than blacks to kill themselves e) People with alocholism are 100% more likely to attempt suicide than people without alcoholism Suicide statistics: 1. National differences a) Britain's, Italy and Spain's sucidie rates are little more than half those of Canada, Australia, and the United States. Austria's and Finland's are about double. Within Europe, people in the most sucidie-prone country (Belarus) have been 16 times more likely to kill themselves than those in the least (Georgia) 2. Racial differences a) Young latinas have the highest rate of attempted suicide in the US compared to any other demographic within the United States, Whites kill themselves twice as often as Blacks 3. Gender differences a) Women are much more likely than men to attempt suicide. But men are two to four times more likely (depending on the country) to actually end their lives. b) Men use more lethal methods, such as firing a bullet into the head, the method of choice in 6 of 10 US suicides. 4. Age differences a) In late adulthood, rates increase, waking in middle age and beyond. In the last half of the 20th century, the global rate of annual suicide deaths nearly doubled. 5. Other differences a) Suicide rates are much higher among the rich, the nonreligious, and those who are single, widowed, or divorced. When facing an unsupportive environment, including family or peer rejection, gay and lesbain youth are at increased risk of attempting suicide 6. DAY OF THE WEEK DIFFERENCES: 25% of suicides occur on Wednesdays 7. When someone is threatening suicide do... a) Take is seriously b) Calmly ask simple questions c) Be a supportive listener d) Emphasize that the unbearable can be survived e) Stay with the person until help arrives f) Encourage them to get professional help 8. When someone is threatening suicide do not... a) Ignore the warning signs b) One of the biggest warning signs is that people give away a bunch of their belongings before they kill themselves c) Refuse to talk about it d) React with horror or disapproval e) Lecture judgmentally: 'You should be thankful..." f) Offer false assurance everything will be alright. g) Abandon the person once the crisis seems to have passed

what is antisocial personality disorder? What are the symptoms?

1. The most troubling and heavily researched personality disorder is the ANTISOCIAL PERSONALITY DISORDER a) Antisocial personality disorder: a personality disorder in which a person (usually a man) exhibits a lack of conscience for wrongdoing, even toward friends and family members. May be aggressive and ruthless or a clever con artists b) The person (sometimes called a sociopath or a psychopath) is typically a male whose lack of conscience becomes plain before age 15, as he begins to lie, steal, fight, or display unrestrained sexual behavior c) About half of such children become antisocial adults-unable to keep a job, irresponsible as a spouse and parent, and assaultive or otherwise criminal d) When the antisocial personality combines a keen intelligence with amorality, the result may be a charming and clever con artists, a ruthless corporate executive, or worse 2. Despite their remorseless and sometimes criminal behavior, criminality is not an essential component of antisocial behavior a) Moreover, many criminals do not fit the description of antisocial personality disorder b) Why? c) Because they actually show responsible concern for their friends and family members d) Antisocial personalities behave impulsively, and then feel and fear little 3. The results sometimes are horrifying as they were in the case of Henry Lee Lucas a) He killed his first victim when he was 13 b) He felt little regret then or later c) He confess that, during his 32 years of crime, he had brutally beaten, suffocated, stabbed, shot, or mutilated some 360 women, men, and children d) For the last 6 years of his reign of terror, Lucas teamed with Elwood Toole, who reportedly slaughtered about 50 people he didn't think was worth living anyhow 4. Diagnosis and symptoms a) Guiltless law breaking, violence, deceit b) Impulsive, irritable, reckless, irresponsible 5. Fact: there are over 29,000,000 psychopaths worldwide a) For the vast majority of spree killer cases, the answer is no-the offender was not a psychopath most killing sprees are committed by individuals who suffer from psychosis, not psychopathy. Recall that psychosis is a fragmentation of the thinking processes in the brain that leads to symptoms like hallucinations and delusions

what is the social cognitive perspective on mood disorders?

1. The social cognitive perspective suggest that depression arises partly from self defeating beliefs and negative explanatory styles a) Depression is a whole body disorder 2. Biological influences contribute to depression but don't fully explain it a) The social cognitive perspective explores the roles of thinking and acting b) Depressed people view life through the dark glasses of low self esteem c) Their intensely negative assumptions about themselves, their situation, and their future lead them to magnify bad experiences and minimize good ones d) Research reveals how SELF DEFEATING BELIEFS AND A NEGATIVE EXPLANATORY STYLE feed depression's vicious cycle 3. Negative Thoughts and Moods

what is the vulnerability of stress hypothesis of schizophrenia?

1. Vulnerability stress hypothesis a) If prenatal viruses and genetic predispositions do not, by themselves, cause schizophrenia, neither do family or social factors alone b) It remains true, as Susan Nicol and Irving Gottesman noted almost three decades ago that no environmental causes have been discovered that will invariably, or even with moderate probability, produce schizophrenia in persons who are not related to a person with schizophrenia c) Hoping to identify environmental triggers of schizophrenia, several investigators are following the development of high risk children, such as those born to a parent with schizophrenia or exposed to prenatal risks d) One study followed 163 teens and early twentieth adults who had two schizophrenia displayed some tendency to withdraw socially and behave oddly before the onset of disorder 2. By comparing the experiences of high risk and low risk children who do versus do not develop schizophrenia, researchers have so far pinpointed the following possible early warning signs: a) A mother whose schizophrenia was severe and long lasting b) Birth complications, often involving oxygen deprivation and low birth weight c) Separation from parents d) Short attention span and poor muscle coordination e) Disruptive or withdrawn behavior f) Emotional unpredictability g) Poor peer relations and solo play h) Most of us can relate more easily to the ups and downs of mood disorders than to the strange thoughts, perceptions, and behaviors of schizophrenia i) Sometimes our thoughts do jump around, but in the absence of disorder we do not talk nonsensically j) Occasionally we feel unjustly suspicious of someone but we do not fear that the world is plotting against s k) Often our perceptions err, but rarely do we see or hear things that are not there l) We have felt regret after laughing at someone's misfortune, but we rarely giggle in response to bad news m) At times we just want to be alone, but we do not live in social isolation n) However, millions of people around the world do talk strangely, suffer delusions, hear nonexistent voices, see things that are not there, laugh, or cry at inappropriate times, or withdraw into private imaginary worlds o) The quest to solve the cruel puzzle of schizophrenia therefore continues, and more vigorously than ever

What is Obsessive compulsive disorder?

1. Was put in its own category in the DSM-5 DSM-4 had it as an anxiety disorder a) Persistence of repetitive thoughts (obsessions) and urges to engage in repetitive behaviors (compulsions) that cause distress b) Responds pretty well to medicines that cause a better reuptake of serotonin c) Severity can have a big difference d) As with generalized anxiety and phobias, we can see aspects of OBSESSIVE-COMPULSIVE DISORDER (OCD) in our everyday behavior e) Obsessive-compulsive disorder (OCD): a disorder characterized by unwanted repetitive thoughts (obsessions) and/or actions (compulsions) 1. We all may at times be obsessed with senseless or offensive thoughts that will not go away a) Or we may engage in compulsive behaviors, perhaps lining up books and pencils just so before studying b) Obsessive thoughts and compulsive behaviors cross the fine line between normality and disorder when they persistently interfere with everyday living and cause distress c) Checking to see you locked the door is normal; checking 10 times is not d) Washing your hands is normal; washing so often that your skin becomes raw is not 2. At some time during their lives, often during their late teens or twenties, 2 to 3% of people cross that line from normal preoccupations and fussiness to debilitation disorder a) Although the person knows them to be irrational, the anxiety fueled obsessive thoughts become so haunting, the compulsive rituals so senselessly time consuming, that effective functioning becomes impossible. b) OCD is more common among teens and young adults than among older people c) A 40 year follow up study of 144 Swedish people diagnosed with the disorder found that, for most, the obsessions and compulsions had gradually lessened, though only 1 in 5 had completely recovered 3. Brain Imaging a) A PET scan of the brain of a person with Obsessive Compulsive Disorder (OCD) b) High metabolic activity (red) in the frontal lobe areas are involved with directing attention c) It used to be an anxiety disorder because people would get bad anxiety if they did not to their repetitive behaviors in response to their obsessions

what is conversion disorder and ilness anxiety disorder?

A somatoform disorder in which a person displays blindness, deafness, or other symptoms of sensory or motor failure without a physical cause / a disorder in which a person experiences very specific genuine physical symptoms for which no physiological basis can be found (also called functional neurological symptom disorder) 1. A woman who goes blind sunday night and would not regain sight until friday evening so during the week when she went to school, she couldn't see anything a) One rare type of disorder, more common in Freud's day than in ours, is CONVERSION DISORDER so called because anxiety presumably is converted into a physical symptom (Frued's effort to treat and understand psychological disorders stemmed from his puzzlement over ailments that had no physiological basis) b) A patient with a conversion disorder might, for example, lose sensation in a ay that makes no neurological sense c) Yet the physical symptoms would be real; sticking pins in the affected area would produce no response d) Other conversion disorder symptoms might be unexplained paralysis, blindness, or an inability to swallow e) In each case, the person would be strangely indifferent to the problem 2. As you can image, somatic symptom and related disorders send people not to a psychologists or psychiatrist but to a physician a) This is especially true of those who experience ILLNESS ANXIETY DISORDER (formerly called hypochondriasis) b) Illness anxiety disorder: a disorder in which a person interprets normal physical sensations as symptoms of a disease (formerly called hypochondriasis) /A somatoform disorder involving strong, unjustified fear of having (VS getting) physical illness c) In this relatively common disorder, people interpret normal sensations ( a stomach cramp today, a headache tomorrow) as symptoms of a dreaded disease. d) Sympathy or temporary relief from everyday demands may reinforce such complaints e) No amount of reassurance by any physician convinces the patient that the trivial symptoms do not reflect a serious illness f) So the patient moves on to another physician, seeking and receiving more medical attention-but failing to confront the disorder's psychological root

What are phobias? What are specific types of phobias? What is social anxiety disorder?

An anxiety disorder marked by a persistent and irrational fear and avoidance of an object, activity, or situation that disrupts behavior a) Phobias have to be irrational (which makes it different from fears which everyone has) 1. Many people accept their phobias and live with them, but others are incapacitated by their efforts to avoid the feared situation a) Marilyn, an otherwise healthy and happy 28 year old fears thunderstorms so intensely that she feels anxious as soon as a weather forecaster mentions possible storms later in the week b) If her husband is away and a storm is forecast, she may stay with a close relative c) During a storm, she hides from windows and buries her head to avoid seeing the lightning 2. Other SPECIFIC PHOBIAS may focus on animals, insects, heights, blood, or enclosed spaces a) People avoid the stimulus that arouses the fear, hiding during thunderstorms or avoiding high places 3. Kinds of phobias a) Agoraphobia: phobia of open places A) Much as fretting over insomnia may, ironically, cause insomnia, so worries about anxiety-perhaps fearing another panic attack, or fearing anxiety caused sweating in public-can amplify anxiety symptoms B) People who have experienced several panic attacks may come to avoid situations where the panic has struck before C) If the fear is intense, it may become AGORAPHOBIA D) Agoraphobia: fear or avoidance of situations, such as crowds or wide open places, where one has felt loss of control and panic E) Given such fear, people may avoid being outside the home, in a crowd, on a bus, or on an elevator b) Acrophobia: phobia of heights c) Claustrophobia: phobia of closed spaces d) Hemophobia: phobia of blood 4. Not all phobias have such specific triggers a) SOCIAL ANXIETY DISORDER (formerly called social phobia) is shyness taken to an extreme b) Social anxiety disorder: intense fear of social situations, leading to avoidance of such (formerly called social phobia) c) Those with social anxiety disorder, an intense fear of being scrutinized by others, avoid potentially embarrassing social situations, such as speaking up, eating out, or going to parties-or will sweat or tremble when doing so d) After spending five years sailing the world, Charles Darwin began suffering panic disorder at age 28 e) Because of the attacks, he moved to the country, avoided social gatherings, and traveled only in his wife's company f) But the relative seclusion did free him to focus on developing his evolutionary theory g) Even ill health, he reflected, has saved me from the distraction of society and its amusements

What is PTSD?

Four or more weeks of the following symptoms constitute post traumatic stress disorder (PTSD): 1. Haunting memories 2. Nightmares 3. Social withdrawal 4. Jumpy anxiety 5. Sleep problems a) Post traumatic stress disorder (PTSD): a disorder characterized by haunting memories, nightmares, social withdrawal, jumpy anxiety, numbness of feeling, and/or insomnia that lingers for four weeks or more after a traumatic experience 1. What defines and explains PTSD is less the event itself than the severity and persistence of the trauma memory a) As an Iraq war soldier, Jesse saw the murder of children, women. It was just horrible for anyone to experience. b) After calling in a helicopter strike on one house where he had seen ammunition crates carried in, he heard the screams of children from within c) I did know there were kids there, he recalls d) Back home in Texas, he suffered real bad flashbacks 2. Our memories exist in part to protect us in the future a) So there is biological wisdom in not being able to forget our most emotional or traumatic experiences-our greatest embarrassments, our worst accidents, our most horrid experiences b) But sometimes, for some of us, the unforgettable takes over our lives c) The complaints of battle scarred veterans such as Jesse-recurring haunting memories and nightmares, a numbed social withdrawal, jumpy anxiety, insomnia-are typical of what once was called shellshock or battle fatigue and nos is called POST TRAUMATIC STRESS DISORDER (PTSD)

what is generalized anxiety disorder?

Generalized anxiety disorder: an anxiety disorder in which a person is continually tense, apprehensive, and in a state of autonomic nervous system arousal 1. Symptoms: a) Persistent and uncontrollable tenseness and apprehension A) No matter what you do, the feeling of worry is still there b) Autonomic arousal A) Heart rate beating faster, sweaty palms, upset stomach c) inability to identify or avoid the cause of certain feelings 2. It is generalized because it is not specific and you cannot pin it on any specific stressor a) Can give you sleep deprivation, jittery, dizzy, and ringing in your ears b) For the past two years,Tom, a 27 year old electrician, has been bothered by dizziness, sweating psalm, heart palpitations, and ringing in his ears c) He feels edgy and sometimes finds himself shaking d) With reasonable success, he hides his symptoms from his family and co-workers, but he allows himself few other social contacts, and occasionally he has to leave work e) His family doctor and a neurologist can find no physical problem f) Tom's unfocused, out of control, agitated feelings suggest a GENERALIZED ANXIETY DISORDER, which is marked by pathological worry g) The symptoms of his disorder are commonplace; their persistence, for six months or more, is not 3. People with this condition-two thirds are women-worry continually, and they are often jittery, agitated, and sleep deprived a) Concentration is difficult as attention switches from worry to worry, and their tension and apprehension may leak out through furrowed brows, twitching eyelids, trembling perspiration, or fidgeting b) One of generalized anxiety disorder's worst characteristics is that the person may not be able to identify and therefore deal with or avoid, its cause 4. To use Sigmund Freud's term, the anxiety is free-floating a) Generalized anxiety disorder is often accompanied by depressed mood, but even without depression it tends to be disabling b) Moreover, it may lead to physical problems, such as high blood pressure c) Most people with generalized anxiety disorder were maltreated and inhibited as children d) As time passes, however, emotions tend to mellow and by age 50, generalized anxiety disorder becomes fairly rare

How many people have or have had a psychological disorder?

More than most of us suppose: 1. The US National Institute of Mental Health estimates that 26% of adult Americans suffer from a diagnosable mental disorder a given year 2. A large scale World Health Organization study based on 90 minute interviews of 60,463 people-estimated the number of prior year mental disorders in 20 countries. The lowest rate of reported mental disorders was in Shanghai, the highest rate in the United States. 3. Moreover, immigrants to the United States from Mexico, Africa, and Asia average better mental health than their native US counterparts. For example, compared with people who have recently immigrated from Mexico, Mexican-Americans born in the United States are at greater risk of mental disorder-a phenomenon known as the immigrant paradox

what is a panic disorder?

Panic Disorder: an anxiety disorder marked by unpredictable, minutes long episodes of intense dread in which a person experiences terror and accompanying chest pain, choking, or other frightening sensations. Often followed by worry over a possible next attack 1. Panic strikes suddenly, wreaks havoc, and disappears a) For the 1 person in 75 with this disorder, anxiety suddenly escalates into a terrifying panic attack-a minutes long episode of intense fear that something horrible is about to happen b) Heart palpitations, shortness of breath, choking sensations, trembling, or dizziness typically accompany the panic, which may be misperceived as a heart attack or other serious physical ailment 2. Smokers have at least a doubled risk of panic disorder because nicotine is a stimulant, lighting up doesn't lighten up a) One woman recalled suddenly feeling "hot and as though I couldn't breathe. My heart was racing and I started to sweat and tremble and I was sure I was going to faint. Then my fingers started to feel numb and tingly and things seemed unreal. It was so bad I wondered if I was dying and asked my husband to take me to the emergency room. But the time we got there (about 10 minutes) the worst of the attack was over and I just felt washed out." 3. Symptoms: a) Minutes long episodes of intense dread which may include feelings of terror, chest pains, choking, or other frightening sensations b) You feel like you are going to die out of no where. You can't breath very good, you feel like your throat is closing in on yourself, chest pain, rapid heartbeat.

What are good medicines to treat mood disorders?

Pharmacology 1. Bipolar disorders most effectively treated with tricyclic antidepressants and lithium Carbonate 2. Lithium serves as a mood stabilizer 3. It is toxic in large doses but does a really good job at keeping people leveled if they are bipolar

what is somatic symptom disorder?

Somatoform disorders a) Psychological problems in which there are symptoms of a physical disorder with NO physical cause /a psychological disorder in which the symptoms take a somatic (bodily) form without apparent physical cause (see conversion disorder and illness anxiety disorder) b) Happens a lot with kids who are being bullied and do not want to go to school c) Among the most common problems bringing people into doctors' offices are medically unexplained illnesses 1. In a SOMATIC SYMPTOM DISORDER, the distressing symptoms take a somatic (bodily) form without apparent physical causes a) One person may have a variety of complaints-vomiting, dizziness, blurred vision, difficulty in swallowing b) Another may experience severe and prolonged pain 2. Culture has a big effect on people's physical complains and how they explain them a) In China, psychological explanations of anxiety and depression are socially less acceptable than in many Western countries, and people less often express the emotional aspects of distress b) The Chinese appear more sensitive to and more willing to report the physical symptoms of their distress c) Mr Wu, a 36 year old technician in Human, illustrates one of China's most common psychological disorders d) He finds work difficult because of his insomnia, fatigue, weakness, and headaches Chinese herbs and Western medicines provide no relief e) To his Chinese clinician, who treats the bodily symptoms, he seems not so much depressed as exhausted f) Similarly, generalized bodily complains have often been observed in African cultures g) Even to people in the West, somatic symptoms are familiar h) To a lesser extent, we have all experienced inexplicable physical symptoms under stress i) It is little comfort to be told that the problem is all in your head j) Although the symptoms may be psychological in origin, they are nevertheless genuinely felt

what are dissociative disorders? What is dissociation?

Sudden loss of memory or change in identity 1. Dissociation a) Protection from extreme stress or shock b) Problems integrating emotional memories 2. Types a) Dissociative amnesia b) Dissociative identity disorder (DID) 3. Dissociation: refers to psychological states in which a person feels disconnected from immediate experience /disorders in which conscious awareness becomes separated (dissociated) from previous memories, thoughts, and feelings 4. Dissociative Disorders: are psychological disorders that involve the sudden loss of memory or change in identity a) Under extreme stress a person's conscious awareness can become split (feel like it is happening to someone else) 3rd person POV b) Among the most bewildering disorders are the rare DISSOCIATIVE DISORDERS c) These are disorders of consciousness, in which a person appears to experience a sudden loss of memory or change in identity, often in response to an overwhelmingly stressful situation d) Chris Sizemore's story, told in the book and movie The three faces of eve, gave early visibility to what is now called DISSOCIATIVE IDENTITY DISORDER e) One Vietnam veteran who was haunted by his comrades' deaths and who had left his World Trade Center office shortly before the 9/11 attack, disappeared en route to work one day and was discovered six months later in a Chicago homeless shelter, reportedly with no memory of his identity or family f) In such FUGUE STATE CASES, the person's conscious awareness is said to dissociated (become separated) from painful memories, thoughts, and feelings g) This explanation presumes the existence of repressed memories, which have been questioned by memory researchers) 5. Dissociation itself is not so rare a) No and then, many people may have a sense of being unreal, of being separated from their body, or watching themselves as if in a movie b) Sometimes we may say "I was not myself at the time." c) Perhaps you can recall getting up to go somewhere and ending up at some unintended location while your mind was preoccupied elsewhere d) Or perhaps you can play a well practiced tune on a guitar or piano while talking to someone e) Facing trauma, dissociative detachment may actually protect a person from being overwhelmed by emotion 6. Dissociative Amnesia: a) Individuals experience extreme memory loss caused by extensive psychological stress

what is the DSM5? How do we catagorize psychological disorders?

The diagnostic and statistical manual of mental disorders (DSM) describes psychological disorders a) The most recent edition, is the DSM-5 and it has 20 classifications of disorders. b) This came out around 2013-2014 and it gets redone every 15 years and remade every 20 years 1. Goals of DSM a) Describe (400) disorders b) Determine how prevalent the disorder is 2. With every edition, we have more and more disorders a) Describe the disorder and then say how common it is b) Disorders outlined by DSM-5 are reliable. Therefore, diagnoses by different professionals are similar 3. In biology and the other sciences, classification creates order a) In psychiatry and psychology, too, classification orders and describes symptoms b) To classify a person's disorder as "schizophrenia" suggests that the person talks incoherently; hallucinates or has delusions (bizarre beliefs); shows either little emotion or inappropriate emotion; or is socially withdrawn. c) Schizophrenia provides a handy shorthand for describing a complex disorder d) In psychiatry and psychology, diagnostic classification aims not only to describe a disorder but also to predict its future course, imply appropriate treatment, and stimulate research into its causes e) Indeed, to study a disorder we must first name and describe it 4. The most common system for describing disorders and estimating how often they occur is the American Psychiatric Association's 2013 Diagnostic and Statistical Manual of Mental Disorders, now in its fifth edition a) Physicians and mental health workers use the detailed diagnostic criteria and codes in the DSM-5 to guide medical diagnoses and define who is eligible for treatments, including medication b) For example, a person may be diagnosed with and treated for insomnia disorder if he or she meets all of the following criteria: A) Is dissatisfied with sleep quantity or quality (difficulty initiating, maintaining, or returning to sleep) B) Sleep disturbance causes distress or impairment in everyday functioning C) Occurs at least three nights per week D) Present for at least three months E) Occurs despite adequate opportunity for sleep F) Is not explained by another sleep disorder (such as narcolepsy) G) Is not caused by substance use or abuse H) Is not caused by other mental disorders or medical conditions 5. In this new DSM edition, some diagnostic labels have changed a) For example, "autism" and "asperger's syndrome" are no longer included; they have been combined into "autism spectrum disorder." b) Mental retardation has become intellectual disability c) New categories include hoarding disorder and binge-eating disorder 6. Some new or altered diagnoses are controversial a) Disruptive mood dysregulation disorder is a new DSM-5 diagnosis for children who exhibit persistent irritability and frequent episodes of behavior outbursts three or more times a week for more than a year b) Will this diagnosis assist parents who struggle with unstable children, or will it turn temper tantrums into a mental disorder and lead to overmedication as the chair of the previous DSM edition has warned c) Others criticize DSM-5 for "putting any kind of behavior within the compass of psychiatry." d) The DSM-5 are Western culture based and critics argue that behaviors by themselves are considered disorders in Western culture, but are not in other cultures e) DSM-5 makes a note to take into account cultural differences when making diagnoses f) Critics have long faulted the DSM for casting too wide a net and bringing almost any kind of behavior within the compass of psychiatry g) They worry that the DSM-5 will extend the pathologizing of everyday life-for example, by turning bereavement grief into depression and boyish rambunctiousness into ADHS h) Other respond that depression and hyperactivity, though needing careful definition, are genuine disorders even, for example, those triggered by a major life stress such as a death when the grief does not go away