Psychological Disorders

Schizophrenia
Literal translation split
mind
The most crippling of the
psychiatric disorders
Costs more than all the
cancers combined
Nobel Prize
Winner John Nash
Subtypes of Schizophrenia
Paranoid
Disorganized
Catatonic
Undifferentiated

Symptoms include:

Disorders of:
thought (e.g., delusions & paranoia)
language (e.g., incoherence, rhyming speech)
perception (e.g., especially auditory hallucinations
70% of schizophrenics report hearing voices)
blunted or inappropriate emotions
strange or odd behaviors (e.g., facial grimaces)

Schizophrenia
Positive symptoms
Hallucinations
delusions
disorganized speech/behavior
Negative symptoms
Isolation
Withdrawal
Apathy
Blunted Emotional Expression

Negative symptoms are less influenced by medications
than positive symptoms
What Causes Schizophrenia?
Genetic
Environmental
Chemical/Biological
Brain abnormalities

Genetic Influences on Schizophrenia
Lifetime risk
of developing
schizophrenia
for relatives of
a schizophrenic

40
30
20
10
0
General
population
Siblings Children Fraternal
twin
Children
of two
schizophrenia
victims
Identical
twin
Environmental Factors
Identical twins dont show 100% concordance, so
there must be an environmental component.
Stress triggers potential risk & can make it worse (but
is hard to measure)
Persons born in winter are more likely to develop
schizophrenia (but only in Northern climates)
In years of influenza epidemics, babies born 3 months
later are at increased risk for schizophrenia (diagnosed
20 years later)
Suggests one potential stressor is pre-natal

Biological bases
Evidence from
brain scans
studies using antipsychotic drugs
drugs decreasing dopamine activity in brain reduce
severity
drugs increasing dopamine in brain (e.g., L-dopa) can
produce schizophrenic-like conditions

dopamine hypothesis: underlying cause of
schizophrenia is excessive stimulation of certain types
of dopamine synapses
Could you fool a psychologist into thinking that you are mad?
Probably!!
Experiment: David Rosenhan (1973)
After admission, behaved normally & no longer complained of
auditory hallucinations
All were admitted and diagnosed as paranoid schizophrenic (+ 1
manic depressive)
Went to psychiatric hospitals & complained of 1
symptom:
Heard voices: empty dull & thud
Faked names & occupations
Otherwise, honest about personal histories
Perfectly normal behavior interpreted as consistent with the idea
they were abnormal
Their Question: At what point would someone detect their
sanity?
The Answer: it never happened (20 hospitals)
Even after study, hospitals persisted, releasing the pseudo-patients
with a diagnosis of schizophrenia in remission.
Rosenhan took notes described as writing behavior
Patient said: had a close relationship with his mother but was rather
remote from his father during his early childhood. During adolescence
and beyond however his father became a close friend while his
relationship with his mother cooled. His present relationship with his
wife was characteristically close and warm. Apart from occasional angry
exchanges, friction was minimal, the children had rarely been spanked.
Clinician explained: This white 39-year old male manifests a long
history of considerable ambivalence in close relationships, which begins
in early childhood. A warm relationship with his mother cools during
adolescence. A distant relationship to his father is described as becoming
very intense. Affective stability is absent. His attempts to control
emotionality with his wife and children are punctuated by angry
outbursts and in the case of the children, spankings. An while he says
that he has several good friends, one senses considerable ambivalence
embedded in those relationships also.
Dissociative Identity
Disorder
Formerly called Multiple Personality Disorder
The presence of 2 or more distinct identities or
personality states that recurrently take control of
behavior.
Each personality has its own memories, behavior
patterns and social relations

Misconception:
schizophrenia = having multiple personalities

Dissociative Identity Disorder
Identities may have contrasting personalities which
may emerge in certain circumstances and may differ
in reported age and gender, vocabulary use, general
attitude and predominant affect.

Time to switch between identities is usually only a
matter of seconds and often accompanied by visible
changes.


Thought experiment
What are 3 of your biggest fears?
Specific phobia types in DSM-IV

Animal type (snakes, spiders)

Natural environment type (heights, storms)

Blood-injection-injury (BII) type (seeing blood, getting a
shot, watching surgery)

Situational type (enclosed spaces, bridges)

Other (vomiting, loud sounds, clowns)
Specific Phobias
Coulrophobia
More Phobias
Myrmecophobia- ants
Phalacrophobia- becoming bald
Hobophobia-bums or beggars
Acrophobia-heights
Pentheraphobia- mother-in-law
Hypengyophobia-responsibility
Venustraphobia- beautiful women
Ailurophobia-cats
Gamophobia- marriage
Ophidiophobia-snakes
Arachnophobia-spiders
Hydrophobia- water
Adaptations to Predators and
Environmental Dangers:
Fears and Phobias
Fears: snakes, spiders,
heights, separation,
darkness, strangers

Responses: freeze, flee,
fight, submit

Developmental timing of
onset of fears: coincides
with adaptive problems
Watch Clips on Phobias
Mood Disorders
Major Depressive Disorder (Unipolar
Depression)
Bipolar Disorder (Manic Depressive
Disorder)
Depression
Common cold of mental illness
17% lifetime prevalence
Twice as common among women as men
Bias in diagnosis?
Self-medicating
Depression much more common among
people born after mid-20
th
century (up to 3
times higher)
Depression
Characteristics
Persistent sadness, gloom
Hopelessness, guilt, worthlessness
Decreased energy, marked changes in
sleeping/eating
Difficulty concentrating, restlessness

Depression
Environmental factors
of recently depressed individuals
experienced preceding negative life event
However, only 1 in 5 experiencing
negative life event develop depression

Depression
Cognitive features
Negative view of themselves, the world,
and the future (cognitive triad)
Attention turned inward (rather than
outward)

Depression
Important Risk factors
Low social support
Low self-esteem
Ruminative response style
Physical/emotional illness
Previous episode of depression
Heredity
Depression
1
Stressful
experiences
4
Cognitive and
behavioral changes
2
Negative
explanatory style
3
Depressed
mood
The vicious
cycle of
depression
Mood Disorders
Bipolar Disorder (Manic Depression)
Characterized by dramatic mood swingsfrom
overly "high" and/or irritable to sad and hopeless,
and then back again, often with periods of normal
mood in between
Depressive episode: usual symptoms of depression
Manic episode
Increasing rates of teen suicide
1% prevalence


Bipolar Disorder
"Manic-depression distorts moods and thoughts, incites
dreadful behaviors, destroys the basis of rational
thought, and too often erodes the desire and will to live.
It is an illness that is biological in its origins, yet one
that feels psychological in the experience of it; an
illness that is unique in conferring advantage and
pleasure, yet one that brings in its wake almost
unendurable suffering and, not infrequently, suicide.

-- Kay Redfield Jamison, Ph.D., An Unquiet Mind, 1995
Bipolar Disorder
Approximately 1 in 5 die
from suicide
Highly heritable
70% concordance rate for MZ
twins, 20% for DZ

PET scan of bipolar brain

Depressed state Manic state Depressed state
Bipolar Disorder