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Introduction to Psychology, 7th Edition, James W.

Kalat
Chapter 16: Specific Disorders and Treatments

Chapter 16

Specific Disorders and Treatments


Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Progress in Abnormal Psychology


The growth of understanding of mental disorders and their
treatment has paralleled the progress of medical science.
Although we have much yet to learn, we now can make
accurate distinctions between a wide range of disorders
and we can tailor treatments to meet the needs of those
suffering from specific disorders.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Module 16.1
Anxiety and Avoidance Disorders
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Disorders Characterized by Excessive Anxiety


Anxiety refers to a certain amount of fear and caution in
the face of potential hazards.
A certain amount of anxiety is normal.

Anxiety is considered pathological when it interferes with

daily functioning.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Disorders Characterized by Excessive Anxiety


Generalized anxiety disorder
Generalized anxiety disorder (GAD) is the experience

of almost constant and exaggerated worry.


There is no basis for the worries but the person is

tense, irritable and tired.


About 5% of the general population will experience

GAD.
Often it is co-diagnosed with other mood disorders

such as depression.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Disorders Characterized by Excessive Anxiety


Panic disorder
Panic disorder (PD) is characterized by frequent

periods of anxiety and occasional attacks of panic.


Panic attacks involve rapid breathing, increased heart

rate, chest pains, sweating, trembling and faintness.


Panic attacks usually last just a few minutes, but can

be much longer.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Disorders Characterized by Excessive Anxiety


Panic disorder
Panic disorder is experienced by 1-3% of adults and

occurs in many cultures.


More women than men are diagnosed with Panic

Disorder.
Hyperventilation, or rapid deep breathing, is a key

symptom.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Disorders Characterized by Excessive Anxiety


Panic disorder
Hyperventilation causes the body to react as if

suffocation were occurring.


The persons subjective interpretation of the symptoms

of hyperventilation can cause an increase in panic or a


calming down.
People with panic disorder tend to interpret these

episodes as uncontrollable and life threatening.


The constant anxiety they experience increases the

likelihood of further panic attacks.


Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Disorders Characterized by Excessive Anxiety


Panic disorder
Treatments for panic disorder include:

Psychotherapy

Anti-depressant drugs

Advice: Dont worry about panic attacks; they wont

kill you.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Disorders Characterized by Excessive Anxiety


Panic disorder
Common co-existing disorders include:

Social phobia severe avoidance of other people

and fear of doing anything in public.


Agoraphobia an intense fear of open or public

places.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Disorders Characterized by Excessive Anxiety


Phobias
Avoidance behaviors are highly resistant to extinction.

Phobia is the most common type disorder involving

avoidance behaviors.
A phobia is strong and persistent fear of a specific object

or situation so strong it interferes with daily living.


Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Disorders Characterized by Excessive Anxiety


Phobias
The Prevalence of Phobias

Not all extreme fears qualify as phobias.

About 11% of U.S. adults suffer from a phobia at

some point in their lives.


About 5-6% are experiencing a phobia at any given

time.
Phobia usually does not persist across the lifetime

many young adults lose them by middle age.


Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Figure 16.2 Most phobias do not last a lifetime. Young people with phobias often lose
them by middle age.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Disorders Characterized by Excessive Avoidance


Phobias
Acquiring a phobia:

Some fears are innate but many are learned.

Some phobias can be traced to a specific event.

The early behaviorists were the first to demonstrate

how fears might be learned.


This does not account for the fact that some phobias

are much more common and easily acquired than


others.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Disorders Characterized by Excessive Avoidance


Phobias
The most common phobias include:

Open spaces

Closed spaces

Heights

Lightening and thunder

Certain animals (snakes, spiders, dogs)

Illnesses/germs
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Figure 16.4 A lab-reared monkey learns to fear snakes from the reactions of a wild-reared
monkey. But if the snake is not visible, the lab-reared monkey fails to learn any fear.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Figure 16.4 A lab-reared monkey learns to fear snakes from the reactions of a wild-reared
monkey. But if the snake is not visible, the lab-reared monkey fails to learn any fear.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Figure 16.4 A lab-reared monkey learns to fear snakes from the reactions of a wild-reared
monkey. But if the snake is not visible, the lab-reared monkey fails to learn any fear.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Disorders Characterized by Excessive Avoidance


Phobias
Behavior therapy for phobias

Systematic desensitization reduces fear by

gradually exposing people to the object under


controlled conditions. Virtual reality is now being
employed for this kind of therapy.
Flooding or implosion a sudden and large-scale

exposure to the object under controlled conditions.


Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Disorders Characterized by Excessive Avoidance


Phobias
Drug therapies for phobias and anxieties

Benzodiazepines, a common type of tranquilizer, are

often prescribed for anxiety disorders.


They suppress symptoms only temporarily and can

be addictive.
Anti-depressants, which are not likely to be taken

habitually, are used more effectively.


Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Disorders Characterized by Excessive Avoidance


Obsessive-compulsive disorder
There are two distressing symptoms that comprise

obsessive-compulsive disorder.
Obsessions are repetitive, unwelcome streams of

thought.
Compulsions are repetitive, almost irresistible

actions.
Obsessive thoughts generally lead to compulsive

actions.
Checking and cleaning are two very common

compulsive behaviors.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Disorders Characterized by Excessive Avoidance


Obsessive-compulsive disorder
Therapies for obsessive-compulsive disorder:

Exposure therapy is very similar to systematic

desensitization.
The patient is exposed to the situation that brings on

the compulsive behavior, but is prevented from


engaging in it.
The most common drug treatments for this disorder

utilize clomipramine and other serotonin reuptake


inhibiters.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Anxieties and Avoidance


Phobias and anxiety disorders involve the interaction and
influence of cognition and emotion upon each other.

People who suffer from these conditions are aware that


their reactions are exaggerated, but this awareness doesnt
cure the problem.

These disorders are challenging but psychologists continue


to improve the efficacy of available treatments.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Module 16.2
Substance-Related Disorders
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Substance Dependence (Addiction)


Individuals who find it difficult or impossible to quit a
dangerous habit are said to have an addiction to it or a
dependence on it.
People vary widely in how this affects their daily lives and
functioning.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Substance Dependence (Addiction)


Nearly all addictive drugs stimulate the dopamine receptors
in the nucleus accumbens.
Activation of these synapses causes increased attention.
This activation is accompanied by feelings of great
pleasure.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Substance Dependence (Addiction)


There are two symptoms involved in the development of a
drug addiction.
Tolerance decreased effects of a given dose.

Withdrawal unpleasant sensations when the drug is

not used (or too little is used given the development of


tolerance).
Activities and substances that are not drugs can produce

addictions suggesting that addiction is a function of the


person, not the drug alone.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Substance Dependence (Addiction)


Is substance dependence a disease?
It depends in part on how we define disease.

Psychologists currently favor the use of continuum from

no addiction to severe addiction.


Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Substance Dependence (Addiction)


Nicotine dependence
Cigarette smoking is based on nicotine addiction.

People are generally able to quit smoking more easily if

they have a replacement source of nicotine (i.e. a patch).


Low-nicotine/low-tar cigarettes do not help people to

quit.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Figure 16.7 Low-nicotine cigarettes have a row of small holes in the filter; room air is supposed to
enter through those holes when the smoker inhales and therefore dilute the tobacco smoke. If
people smoke such cigarettes without covering the air holes, little tar and nicotine pass through the
cigarette, as we see from the relatively clean filter tip. However, if people cover the holes with their
fingers or tape, they will
receive about as much tar and nicotine as they would from any other filtered cigarette.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Substance Dependence (Addiction)


Alcoholism
Alcoholism is defined as the habitual overuse of alcohol.

Treatment of chronic alcoholism is very difficult.

In order for treatment of alcoholism to be effective, we

need to detect the problem in its early stages.


We need to identify the factors that put certain people at

risk.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Substance Dependence (Addiction)


Alcoholism
Type I alcoholism develops gradually over the lifespan.

It is equally prevalent in men and women.

It is generally less severe in its health consequences.

Type II alcoholism has an early onset.

It is much more prevalent in men and more severe.


Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Table 16.3 Type I and Type II alcoholism


Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Substance Dependence (Addiction)


Alcoholism: Risk factors
Research studies indicate that tendency to addiction is

influenced by genetics.
Type II alcoholism shows a strong genetic basis.

Some people with no family history of alcoholism

develop an alcohol problem.


Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Substance Dependence (Addiction)


Alcoholism: Risk factors
Exposure to parental conflict, inadequate supervision,

and abuse can increase the likelihood of alcoholism


emerging later in life.
Culture also has an influence prevalence rates vary in

different nations and ethnic groups.


Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Substance Dependence (Addiction)


Treatment for alcoholism
It is very difficult for most people to quit alcohol and the

other drugs.
Only 10-20% are successful and relapses are very

common.
Many recovering addicts seek help from mental-health

professionals or self-help groups.


Such help improves the chances of successful recovery,

but offers no guarantees.


Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Substance Dependence (Addiction)


Treatments for alcoholism
Detoxification is a program of supervised recovery

provided in a hospital setting.


Outpatient mental-health treatment has about the same

rate of success as detoxification.


Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Substance Dependence (Addiction)


Treatments for alcoholism
The most widespread treatment for alcoholism is offered

by Alcoholic Anonymous (AA).


AA is a self-help group comprised of people who abstain

from alcohol use and offer help and support to each


other.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Substance Dependence (Addiction)


Treatments for alcoholism
Antabuse is the trade name for disulfiram.

Alcoholics who take Antabuse daily become very sick

when they drink alcohol.


This treatment is only moderately effective.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Substance Dependence (Addiction)


Treatments for alcoholism
Controlled drinking refers to reducing consumption of

alcohol from dependent/abusive to moderate levels.


Some physicians believe that abstinence is workable for

all alcoholics and believe this is a viable alternative.


Harm reduction is a similar approach applied to drug

abuse.
These methods are highly controversial
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Substance Dependence (Addiction)


Opiate dependence
A very difficult withdrawal syndrome complicates

recovery from dependence on opiate drugs (i.e. heroin,


morphine).
Some opiate addicts go cold turkey in order to stop

using.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Substance Dependence (Addiction)


Opiate dependence
Recovery programs commonly offer methadone as a

less dangerous replacement for opiates.


This is a harm reduction strategy that allows recovering

opiate addicts to remain employed and avoid criminal


behavior.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Table 16.4 Comparison of methadone with morphine


Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Substances, the Individual, and Society


How we handle the problem of substance dependence and
abuse in our society remains an area of intense debate.

Our current strategies have not eliminated widespread use.

As a citizen, you may be called upon to think about these


issues and help to shape changes in our national drug
policy. As you have learned, there are complex and difficult
issues involved.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Module 16.3
Mood Disorders
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Mood Disorders
Depression
Major depression

Major depression is an extreme condition.

It usually persists for months.

The person experiences little interest in anything, little

pleasure, and little motivation to be productive.


Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Mood Disorders
Depression
Major depression

Loss of interest in food and sex are common.

The person has feelings of worthlessness, guilt and

powerlessness over their lives.


Sleep abnormalities are associated with depression

(there is a characteristic rapid onset of REM sleep).


The person may attempt suicide.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Figure 16.9 When most people go to sleep at their usual time, they progress slowly to
stage 4 and then back through stages 3 and 2, reaching REM sleep toward the end of
their first 90-minute cycle. Depressed people, however, reach REM more rapidly,
generally in less than 45 minutes. They also tend to awaken frequently during the
night.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Mood Disorders
Depression
Seasonal affective disorder (SAD)

Consistent depression associated with a particular

season of winter is called seasonal affective


disorder.
It is most common in areas that have little sunlight in

the winter.
It can be relieved by light therapy, which requires the

depressed person to sit in front of a bright light for a


few hours each day.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Figure 16.10 Most people feel slightly better during the summer (when the sun is out most of the day)
than during the winter (when there are fewer hours of sunlight). People with seasonal affective disorder
(SAD) feel good in the summer and seriously depressed in the winter (or good in the winter and
depressed in the summer). Seasonal affective disorder is commonest in far northern locations such as
Scandinavia, where the summer days are very long and bright and the winter days are very short and
dark. The disorder is unheard-of in tropical locations such as Hawaii, where the amount of sunlight per
day varies only slightly between summer and winter.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Mood Disorders
Depression
Bipolar disorder

This condition was once referred to as manic-

depressive disorder.
It involves a cycling of mood between periods of

depression and periods of mania.


Mania is a state of extreme exuberance and agitation.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Mood Disorders
Depression
Genetic predisposition to depression

Having close biological relatives who were diagnosed

with depression increases ones probability of


becoming depressed.
Having adoptive relatives who were depressed also

increases that probability, but not as much.


Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Mood Disorders
Depression
Genetic predisposition to depression

The probability is especially high if one has biological

relatives who were diagnosed with depression before


age 30.
There is probably no one gene that causes

depression.
Genes probably influence temperament and therefore

also the way people respond to events in their lives.


Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Mood Disorders
Depression
Sex differences in depression

Before adolescence, depression is about equally

common in boys and girls.


From adolescence onward, women are about twice

as likely to experience depression as men.


Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Mood Disorders
Depression
Sex differences in depression: hormones

Women experience more rapid hormonal changes

than men do (menstrual cycles, pregnancy, childbirth


and menopause).
Postpartum depression is triggered by the rapid

hormonal changes that follow childbirth.


However, the hormone levels of depressed women

are not significantly different that those of non-


depressed women.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Mood Disorders
Depression
Sex differences in depression: coping

Men generally try to distract themselves when they

are feeling depressed. Women tend to dwell on their


feelings more.
Ruminating may not be useful for coping and may

make the person feel worse.


This explanation does not account for why women

and men choose different strategies.


Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Mood Disorders
Depression
Events that precipitate depression

People generally become depressed after losses or

other negative events occur.


There is little relationship between the scale of the

event and the intensity and duration of the


subsequent depression.
Severe losses early in life may make people more

vulnerable to depression later on in life.


Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Mood Disorders
Depression
Events that precipitate depression

Lack of social support also increases vulnerability to

depression.
As in the case of stress, it is not just the event but

also the persons interpretation of the events


significance that influences the degree of depression.
The way people think about their lives, as well as the

course of the events, is a factor to consider.


Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Mood Disorders
Depression
Cognitive aspects of depression

Every person has an explanatory style in accounting

for successes and failures.


Internal attributions cite causes within the person.

External attributions identify causes outside the

person.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Mood Disorders
Depression
Cognitive aspects of depression

People tend to be more consistent in the type of

attributions that they use to explain their failures.


People who blame themselves for all failures,

regardless of the circumstances, develop a


pessimistic explanatory style.
They view their failures as global (consistent over

situations) and stable (consistent over time).

Depressed people believe that every silver lining has a


cloud.
-- Kalat
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Mood Disorders
Depression
Treatments for depression

Cognitive therapy helps the individual develop more

positive beliefs.
Drug therapies use anti-depressant medications

including the tricyclics, selective serotonin


reuptake inhibitors, monoamine oxidase
inhibitors, and atypical antidepressants.
St. Johns Wort is a naturally occurring herb that has

antidepressant effects. It should not be used with


other medications.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Figure 16.13 Antidepressant drugs prolong the activity of the neurotransmitters


dopamine, norepinephrine, and serotonin. (a) Ordinarily, after the release of one of the
neurotransmitters, some of the molecules are reabsorbed by the terminal button, and
other molecules are broken down by the enzyme monoamine oxidase (MAO). (b)
Selective serotonin reuptake inhibitors (SSRIs) prevent reabsorption of serotonin.
Tricyclic drugs prevent reabsorption of dopamine, norepinephrine, and serotonin. (c)
MAO inhibitors (MAOIs) block the enzyme monoamine oxidase and thereby prolong the
effects of the neurotransmitters.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Mood Disorders
Depression
Treatments for depression

Electroconvulsive shock therapy (ECT) is a well-

known but controversial treatment.


A brief electrical shock is administered to the patients

head.
It induces a convulsion similar to an epileptic seizure.

How it works is not fully understood.


Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Mood Disorders
Depression
Treatments for depression

It is an effective treatment, although the benefits are

temporary. Other treatments must be offered also.


ECT fell out of favor because it was widely abused

(administered without patient consent, given too


often, used as a threat).
It is now used only for patients who have treatment-

resistant depressions or who are strongly suicidal.


Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Mood Disorders
Bipolar disorder
Bipolar disorder: symptoms

People whose moods alternate between extremes of

mania and depression are said to suffer from bipolar


disorder.
When they are experiencing mania, they are

constantly active and uninhibited, and may be very


happy or very irritable.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Mood Disorders
Bipolar Disorder
Bipolar Disorder: types

Psychologists diagnose two types of bipolar disorder.

Bipolar I disorder involves the experience of at least

one episode of mania.


Bipolar II disorder involves alternation between

major depression and hypomania, which is a milder


form of mania.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Mood Disorders
Bipolar disorder
Bipolar disorder: prevalence

About 1% of the adult population of the U.S. has been

diagnosed with a Bipolar Disorder.


It can be difficult to distinguish bipolar from other

disorders (attention deficits, delusions and


hallucinations are also symptoms of other disorders).
There are hereditary influences on bipolar disorder.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Mood Disorders
Bipolar disorder
Drug therapies for bipolar disorder

Lithium is a naturally occurring chemical that is used

to treat mania.
How lithium relieves mania is not well understood.

Lithium is toxic at high doses, so a patient who takes

it must be carefully monitored.


Valproate and anticonvulsant drugs are also used

to treat bipolar disorders.


Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Mood Disorders
Suicide
Mood disorders and suicide

People who suffer from depression and bipolar

disorders consider suicide. Some make attempts.


It is hard to know the true rate of suicide because

some suicides are disguised to look like accidents.


Suicide rates vary as a function of gender, culture and

age
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Figure 16.15 Suicide rates differ as a function of age, gender, and culture. The rates shown
here are for 1988; the rate has dropped since then for Hungary, presumably because of
economic and social changes within the country. (Based on data of Lester, 1996)
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Figure 16.15 Suicide rates differ as a function of age, gender, and culture. The rates shown
here are for 1988; the rate has dropped since then for Hungary, presumably because of
economic and social changes within the country. (Based on data of Lester, 1996)
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Table 16.5 People most likely to attempt suicide


Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Mood Disorders
Suicide
Mood disorders and suicide

Women make more attempts but tend to employ less

lethal means than do men.


There is no dependable pattern to suicide, but certain

warning signs and risk factors are associated with it.


Previous attempts, a history of losses, a recent loss,

and a family history are all likely to raise the risk.


Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Mood Disorders
Suicide
Mood disorders and suicide

If someone you know is thinking of suicide, try to treat

the person as you would any other person who is in


distress.
Offer support and friendship, and dont be afraid to

ask him or her to talk about feelings.


Encourage the person to seek professional help if you

sense that they are open to the suggestion.


Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Mood and Mood Disorders


Our capacity to experience emotions is an important part of
our lives. We have a wide range of pleasant and
unpleasant feelings to color our days.

Mood disorders go beyond this typical spectrum, and


victimize the person, distorting their perspective. Our ways
to manage these disorders have improved over the past
decades, providing many with relief from this distortion.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Module 16.4
Schizophrenia
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Schizophrenia
What is schizophrenia?
Many people confuse the term schizophrenia with

dissociative identity disorder or multiple personality


disorder.
The split in schizophrenia refers to a disconnection of

the intellectual and emotional aspects of the personality.


Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Figure 16.16 Although the term schizophrenia is derived from Greek roots meaning split
personality, it does not refer to cases where people alternate among different
personalities. Rather, the term originally indicated a split between the intellectual and
emotional aspects of a single personality.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Schizophrenia
What is schizophrenia?
The DSM-IV diagnosis of schizophrenia requires that the

person exhibit a complete deterioration of daily activities


along with at least two of the following symptoms:
Hallucinations

Delusions or thought disorders

Incoherent speech

Grossly disorganized behavior

Loss of normal emotional responses and social

behaviors
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Schizophrenia
Symptoms of schizophrenia
It is possible for two people with schizophrenia to have

very different symptom patterns


The symptoms are divided into two broad types.

Positive symptoms are behaviors that are notable

because of their presence (hallucinations and


delusions, for example).
Negative symptoms are behaviors that are notable

because of their absence (lack of emotional


expression).
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Schizophrenia
Symptoms of schizophrenia
Positive symptoms

Hallucinations are false sensory experiences.

Hearing voices is a common auditory hallucination of

schizophrenia.
Visual hallucinations occur but are less common.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Schizophrenia
Symptoms of schizophrenia
Positive symptoms

Delusions are unfounded beliefs.

There are three types of delusions associated with

schizophrenia persecution, grandeur, and ideas


of reference.
As it is sometimes hard to distinguish between the

unusual opinion and a delusion, one cannot diagnose


a psychotic disorder on the basis of such ideas alone.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Schizophrenia
Symptoms of schizophrenia
Positive symptoms

Disordered thinking refers to a deficit in utilizing

executive functions.
Deficits of attention, difficulty in switching rules and

routines, loose associations, and difficulties with


abstraction are all common types of disordered
thinking in people suffering from schizophrenia.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Schizophrenia
Types and prevalence
Four types of schizophrenia

Undifferentiated

Catatonic

Disorganized

Paranoid
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Schizophrenia
Four types of schizophrenia
The symptoms of undifferentiated schizophrenia

include:
Deterioration of daily functioning

Hallucinations

Delusions or thought disorders

Inappropriate emotions

None of the symptoms is unusually pronounced or

bizarre.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Schizophrenia
Four types of schizophrenia
Catatonic schizophrenia is distinguished by prominent

movement disorder, including either:


Rigid inactivity

Excessive activity

The person is aware of his or her surroundings, but

the nature of the individuals posture or movement


has no relationship to the outside world.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Schizophrenia
Four types of schizophrenia
The symptoms of disorganized schizophrenia include:

Incoherent speech

Extreme lack of social relationships

Silly or odd behavior


Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Schizophrenia
Four types of schizophrenia
The symptoms of paranoid schizophrenia include:

Elaborate hallucinations and delusions

The delusions have pronounced themes of

persecution and grandeur.


Other thought problems tend to be less pronounced,

and some people with paranoid schizophrenia are


relatively intact cognitively.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Schizophrenia
Prevalence
Prevalence of schizophrenia

About 1% of Americans are afflicted with

schizophrenia at some time in the lifespan.


In general, the rates of this disorder have been

declining over the past 100 years.


It occurs in many cultures, but is less common in

developing nations.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Schizophrenia
Prevalence
Prevalence of schizophrenia

Schizophrenia is most frequently diagnosed in young

adults.
Men are usually diagnosed earlier than women.

The onset is typically sudden, although there are

some markers during childhood.


Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Schizophrenia
Causes
Genetic influences

Studies of twins and adopted children suggest a

genetic basis for the disease.


In identical twins, if one member of the pair develops

schizophrenia, there is a 50% chance that the other


will also.
As with most other genetic research, it is difficult to

control for the effects of the prenatal environment.


Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Figure 16.18 The relatives of a schizophrenic person have an increased probability of


developing schizophrenia themselves. Note that children of a schizophrenic mother have
a 17% risk of schizophrenia even if adopted by a family with no schizophrenic members.
(Based on data from Gottesman, 1991)
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Schizophrenia
Causes
Genetic influences

So far researchers have not located a specific gene

for schizophrenia.
It is probably not a single-gene disorder.

It appears that certain people develop it without a

genetic basis.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Schizophrenia
Causes
Brain damage may have some influence on the

development of schizophrenia. Brain scans indicate that:


The hippocampus and parts of the cerebral cortex are

a little smaller than normal.


The cerebral ventricles are larger than normal.

People with schizophrenia have smaller neurons and

fewer synapses in the prefrontal cortex.


Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Schizophrenia
Causes
The neurodevelopmental hypothesis

The neurodevelopmental hypothesis states that

schizophrenia is the result of nervous system


impairments that develop before or at birth.
These impairments may be due to genetic or other

reasons.
Non-genetic risk factors include: poor prenatal care,

difficult pregnancy and labor, and mothers exposure


to influenza virus.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Schizophrenia
Therapies for schizophrenia
Drug therapies

Antipsychotic or neuroleptic drugs help to relieve

the symptoms of schizophrenia.


These drugs work gradually and vary in effectiveness

from patient to patient.


Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Schizophrenia
Therapies for schizophrenia
Drug therapies

Antipsychotic drugs work to block the production of

dopamine at the synapses, which is evidence for the


dopamine hypothesis of schizophrenia.
An alternative explanation is the glutamate

hypothesis of schizophrenia, which is supported by


the deficient stimulation of glutamate (a
neurotransmitter that is inhibited by dopamine).
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Schizophrenia
Therapies for schizophrenia
Drug therapies

Tremors and involuntary movements begin gradually

in people taking antipsychotics for many years, a


condition known as tardive dyskinesia.
Atypical antipsychotic medications have been

developed to provide relief without this troublesome


side effect.
The atypical antipsychotics tend to suppress immune

functioning in many patients, however.


Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Schizophrenia
Therapies for schizophrenia
Family therapy for schizophrenia

Because caring for a schizophrenic family member

can be stressful, family therapy can be useful in a


number of ways.
It provides direct support for the healthy family

members.
It reduces the additional risk to the patient by

circumventing negative reactions to him or her by


family members that might promote relapse.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

Figure 16.20 This graph indicates that during 2 1/2 years following apparent recovery from
schizophrenia, the percentage of schizophrenic patients who remained improved is higher
in the group that received continuing drug treatment than in the placebo group. But the
graph also shows that antipsychotic drugs do not always prevent relapse. (Based on
Baldessarini, 1984)
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments

The Elusiveness of Schizophrenia


Two people with schizophrenia may present their illness in
very different ways. The causes of their illnesses may turn
out to be very different.

Psychologists are still uncertain whether we are looking at


one disorder or several. We still have so much to learn
about this complex illness.

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