Mood Disorders

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Transcript Mood Disorders

(7th Ed)
Chapter 16
Psychological Disorders
James A. McCubbin, PhD
Clemson University
Worth Publishers
Ch. 16: Psy Disorders: “harmful dysfunction”
in which behavior is judged to be…
A. Atypical (violates social-norms): goes against
accepted behaviors; but not enough by itself
to be a mental disorder…
---Varies w/ era & culture
B. Disturbing: causes distress to you or those
around you-C. Maladaptive—harmful; keeps you from
functioning well in your world
D. Unjustifiable: no apparent reason….sometimes
there’s a good reason
Historical Perspective
 Formerly Perceived Causes
 movements of sun or moon
 lunacy--full moon
 evil spirits; demons ; witches
 Ancient Treatments
 exorcism, caged like animals, beaten, burned,
castrated, mutilated, blood replaced w/ animal’s
 Lock into attics…chain them up
 Changing from “demons” to illness:
-Paris: Philippe Pinel: became head of a mental
hospital in 1700’s & saw horrid ways patients were
treated…unchained the people & demanded humane
Psychological Disorders
 Medical Model
 concept that diseases have physical causes
 can be diagnosed, treated, (& in most cases) cured
 assumes “mental” illnesses can be diagnosed on
the basis of their symptoms & cured through
therapy…& may include treatment in a
psychiatric hospital
 Used to use psych. hospitals a lot but now most
is on out-patient basis
 Bio-Psycho-Social Perspective: assumes that
biological, socio-cultural, & psychological factors
combine & interact to produce psychological
--a combination of causes in a cycle
Psychological Disorders:
Biopsychosocial AGAIN! 
The causes of a disorder or condition --where it
comes from…It’s ORIGINS…
Freudians (psychoanalystic  now
psychodynamic ) said childhood experiences &
anxiety & “fixations” in various stages caused
disorders & symptoms
Rogers & Maslow (humanists) said it had to do
with concept of “the self” and how society
saw/defined you
The DSM: Diagnostic & Statistical Manual of
Mental Disorders
 DSM: classifies a disorder…mainly the symptoms that
define that disorder Diagnostic & Statistical Manual of
Mental Disorders from American Psychiatric Association’s
(4th Edition) = DSM-IV-TR (text revision... WAS the
 a widely used system for classifying & defining what
constitutes a particular psychological disorders
 It does NOT give the Etiology….AND does NOT tell you
how to treat a disorder
EX: Psychologists used to classify homosexuality as a
mental disorder but when they did the last major revisions
(DSM-IV, late ’70’s) it was changed & is no longer
considered a disorder
Match the Famous ppl w/ mental disorder NOTE: Some may have more than 1 disorder,
some disorders have more than one person affected
Bipolar Disorder
DID (Dissociative identity disorder)
OCD (obsessive compulsive disorder)
Panic Attacks
Post-partum depression
Social Anxiety
Substance Abuse
(answers on LAST slide)
Joan Baez
Craig Ferguson
Paula Deen
Howard Hughes
Brooke Shields
Vincent van Gogh
Emma Thompson
Michael Phelps
Elton John
Herschel Walker
Carrie Fisher
John Nash
Neurosis vs. Psychosis according to Freud:
2 Important terms Freud used: neurosis & psychosis:
Neurosis: various mental/emotional disorders, such as
hypochondria or depression, arising from no apparent
organic lesion or change
Involves symptoms such as insecurity, anxiety, depression, &
irrational fears, but without psychotic symptoms such as
delusions or hallucinations. No longer in scientific use.
Psychosis: having more severe symptoms of disorders:
hallucinations, delusions
This IS still used to describe symptoms like hallucinations
& delusions—refers to a “break with reality” –meaning
see/hear stuff not there…..think some pretty bizarre things
are true—like aliens are listening to your thoughts…
Psychological Disorders-
DSM-V (DSM-5) is coming out very soon….like this month!)
DSM classifies disorders into a category….major categories
are “axes” (plural of “axis”)
Major divisions of mental disorders (there are others):
*anxiety disord. *schizophrenia *dissociative disord.
*mood disorders *personality disord. *somatoform
Psychotic disorders
Person loses contact w/ reality, experiencing irrational
ideas & distorted perceptions
Commonly seen in schizophrenia & more severe bipolar
disorders as well as others
Neurotic Disorders: usually distressing/upsetting but…
allows one to think rationally & function socially
(this term is seldom used now)
Anxiety Disorders: distressing, persistent anxiety or
maladaptive behaviors that reduce anxiety for no
apparent or rational reason (these are not rare…)
 Panic Disorder (panic attacks): marked by a minuteslong episode of intense dread in which a person
experiences terror and accompanying chest pain,
choking, or other frightening sensation
 Often diagnosed in ER…why?
 Generalized Anxiety Disorder: person is tense,
apprehensive, and in a state of autonomic nervous
system arousal
 Phobia: persistent, irrational fear of a specific object or
 Agoraphobia: fear of unfamiliar places…fear of being
away from home
 Obsessive-Compulsive Disorder: unwanted repetitive
thoughts (obsessions) and/or actions (compulsions)11
 Anxiety Disorders: NOTE: There are many more than
just those most common ones on the previous slide…
 Common & uncommon fears: extremes = phobias
Anxiety Disorders: OCD
obsessions & compulsions: Kids & adolescents
Explaining anxiety disorders: etiology– cause?
 fear conditioning: bad uncontrollable events can
cause these (rape victim?)
EX: PTSD: post-traumatic stress disorder
 stimulus generalization: person falls…then fears
 reinforcement: becomes cyclic: anxiety, so do
something to relieve it (run away, stay home,
etc.), feel better, so you will do this the next time
 observational learning: parents, siblings, etc.
teach fears to the young
 genetic: thru natural selection (many are
 physiological: folks w/ overactive limbic system
can be prone to these disorders…& antidepressants help them
Anxiety Disorders
PET Scan of brain of
compulsive disorder
 High metabolic
activity (red) in
frontal lobe areas
involved with
directing attention
 Over-active amygdala
&/or limbic system
can affect this
 ** b/c it’s a stimulant,
nicotine increases
risk of a 1st episode
of anxiety disorders
Mood Disorders: Emotional extremes (ups OR downs)
Mild or moderate Depression (aka dysthymic disor.):
“common cold” of mental disorders…
Related to lack of N-T’s serotonin & nor-epinephrine
(both affect mood) and can have genetic
Women more prone to depression…probably b/c of
**Lack of self-esteem
**Lack of a sense of efficacy ( “I have control, etc.)
Major Depressive
For no apparent reason,
person experiences 2 or more
wks of depressed moods,
feelings of worthlessness,
& diminished interest or
pleasure in most activities
 Possibility of suicide is
major concern
 If drugs &
cognitive/behavioral therapy
don’t work, this is 1 of few
disorders Dr’s. may still use
shock (ECTelectroconvulsive) therapy
on b/c of fear of suicide
Mood Disorders
Manic Episodes
Marked by a hyperactive,
wildly optimistic state
Biological influence: *maybe genetics or..*excess of 2
(maybe 3?) NT’s?
( s___ & especially n___ maybe d__)
EX’s of manic behaviors: Could be 1, some, or all (or
some other…) of the following:
-grandiose ideas
-euphoric optimism
-spending sprees
-reckless, aggressive
-long periods of no sleep
-speech becomes loud
-excessive self-esteem
-poor judgment, egocentric
-increased chances of unprotected sex
Bipolar Disorder
 Mood disorder in
which the person
alternates betwn.
the hopelessness
& lethargy of
depression… & the
overexcited state
of mania
 A “self-portrait”
 way up…then way
down…& back
 formerly called
Mood Disorders-Bipolar
 PET scans show that brain energy consumption
rises & falls w/ emotional switches…same person in
all 3 of these PET scans
 May 17
Depressed state
May 18
Manic state
Depressed state
Suicides & differing groups:
 National: see #’s: where’s US?
 Racial: Euro.-Amer.(W) more than Afr. Amer. (B)
 Gender: Which try? Which succeed? Why?
 Age: most = older men; increase in older male
 Other groups:
religious vs. non-relig.
married, single, widowed, divorced?
drug usage?
The Depressed brain:
How do serotonin & norepinephrine affect depression vs.
mania?? (Dopamine MAY be involved also)
Mood Disorders - Depression &
Gender cross-culturally:
Females more susceptible
Mood Disorders-Depression
 Canadian depression rates: M vs F in varying ages
Mood Disorders- Suicide
Why do more F’s attempt suicide but more M’s
commit suicide?
Why does rate in males go up sharply in later yrs.?
Mood Disorders-Depression
Altering any one
component of the
chemistry-cognitionmood circuit can alter
the others
 Genetic: there is a
strong genetic link in
mood disorders
 Physiological (638)
brains differences:
lobes, NT’s, activity
 Social-cognitive: selfdefeating beliefs;
negative thoughts
-”stable, global,
internal” (b-640)
Mood Disorders-Depression
 The vicious
cycle of
depression can
be broken at
any point
 Rumination:
dwelling on
P. 643:
often breeds
Dissociative Disorders
(Read 644-5)
 conscious awareness becomes separated (dissociated)
from previous memories, thoughts, and feelings
 Dissociative amnesia: blocking of information regarding a
very stressful event; just go on w/ life like it never
happened (Freud’s repression)
 Dissociative Fugue: go to new place & take up new life
after some traumatic event
 Dissociative Identity Disorder
 rare dissociative disorder in which a person exhibits two
or more distinct and alternating personalities
 formerly called multiple personality disorder
 Some psychologists disbelieve this, say it’s role-playing
 It is NOT schizophrenia (though you’ll hear it called that)
 V. rare & disputed by most psychologists
 Virtually always related to long-term childhood sexual
 Schizophrenia: This one IS very real…& very sad…
 literal translation “split mind” which is why may
hear schiz. called multi. personality
 a group of severe disorders characterized by:
 disorganized and delusional thinking
 disturbed perceptions
 inappropriate emotions and actions
 Delusions
 false beliefs, often of persecution or grandeur,
that may accompany psychotic disorders
 Hallucinations
 sensory experiences without sensory stimulation29
Schizophrenic Art:
also 
5 subtypes of schizophrenia:
Also… Acute vs. chronic?
Schizophrenia: Etiology: Genetic component
Schizophrenia in ID Twins: 1 w/ & 1 w/o
--indicates some other cause other than
genetics… NOTE size of ventricles
Positive vs. negative symptoms …
These do NOT relate to good or bad…
Positive: something added…
EX: hallucinations; delusions; excessive
Negative: something taken away…
EX: -flat affect (no emotion)
-no movement (catatonic)
Onset of schiz.: those predisposed to schiz.
have their 1st episode typically between about
ages 17 – 35
--some possible warning signs…
EX: poor selective attention
Clarification: Positive vs. Negative
Schiz. symptoms
Positive symptoms are things that are
present in schizophrenics which are
absent in normal people, such as
delusions, hallucinations, or word salad.
Negative symptoms are things which are
absent in schizophrenics which are
present in normal people, such as flat
affect, avolition (lack of motivation, etc.) or
Etiology of schizophrenia:
Environment: Other disorders have effects from
from the environment, BUT schiz. very much
…BUT stress can bring on episodes in those who have
physiological tendencies already
EX: family interaction & communication can have an
effect (Hi-risk factors RE: schiz.: p. 652)
Dopamine over-activity: too much dopamine in
brains of schiz. during autopsies
Brain anatomy: low activity in frontal lobes;
enlarged brain cavities (ventricles)
Maternal viruses during mid-pregnancy: is it
the virus, or the medications, etc.?
But only 2% seem affected this way…
Genetic factors: there is a genetic link …so if you
have a close family member w/ schiz., risk is up
Personality Disorders: inflexible, long-lasting behavior
patterns that impair social functioning usually
without anxiety, depression, or delusions
(SOME below......BUT are others!)
 Borderline Personality Disorder: manipulative; can be
sexually promiscuous; defensive; high-risk; may
threaten suicide for attention
 Co-dependent Persn. Disor.: over-dependent on
another; will allow another to abuse verbally,
emotionally, etc., & tend to make excuses for him/her
-usually women; “passive-aggressive”
 Narcissistic Persn. Disor.: It’s ALL about MEEEE!!!
 Antisocial Persn. Disor. (aka “sociopaths”)
 person (usually male) exhibits a lack of conscience
for wrongdoing, even toward friends & family
 may be aggressive and ruthless or a clever con artist
 Early signs? (See “ppl who abuse animals…”)
Anti-social personality disorder:
little guilt or effect
 Boys who
were later
convicted of
a crime
relatively low
during stress
Antisocial-Personality Disorders
 PET scans illustrate reduced activation in a
murderer’s frontal cortex…lacks guilt, etc.
 Less related to genetics, more environ.
..\..\Desktop\stored documents\videos psych etc from toshiba JD\Video folder
2013\A Conversation with Richard Ramirez--The Night Stalker--Reported by Mike
Watkiss - YouTube.mp4
Personality Disorders: Do seem to have an
environmental etiology...often abusive, poor,
neglectful parents are involved + birth problems
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folder 2013\Psych Stuff antisocial personality disorder.flv
Rates of Psychological Disorders: Hi? Lo? Cultural /gender ?
..\AP Psych Docs folder Jan 2012\AP Psy
Psych Disorders and Their Statistics
Somatoform disorders:
(Not in yr bk!)
-Preoccupation w/ health…or showing physical
symptoms w/ NO true physical problems
Conversion disorder: used to be called
“hysterical ___”, i.e., hysterical blindness or
hysterical paralysis
Hypochodriasis: hypochondria…preoccupied
w/ your health, worried you have everything
Munchausen’s Syndrome or Munchausen
by proxy: actually poison or otherwise hurt
yourself (or another= proxy) in order to get
sympathetic attention (any movie you remember?)
Answers to
Match the famous ppl w/ mental disorders
ADHD: Michael Phelps
Agoraphobia: Paula Deen
Bipolar Disorder: Carrie Fisher, Vincent van Gogh
Bulimia: Elton John
Depression: Emma Thompson
Dissociative identity disorder (DID): Herschel Walker
OCD: Howard Hughes
Panic Attacks: Paula Deen
Post-partum depression: Brooke Shields
Schizophrenia: John Nash
Social Anxiety: Joan Baez
Substance Abuse: Craig Ferguson, Elton John