Psychological Science, 3rd Edition Michael Gazzaniga Todd Heatherton Diane Halpern

1. Psychological Science, 3rd EditionMichael Gazzaniga Todd Heatherton Diane Halpern

2. Disorders of the Mind and Body 14

3. Questions to Consider: How Are Mental Disorders Conceptualized and Classified? Can Anxiety Be the Root of Seemingly Different Disorders? Are Mood Disorders Extreme Manifestations of Normal Moods? What Is Schizophrenia? Are Personality Disorders Truly Mental Disorders? Should Childhood Disorders Be Considered a Unique Category?

4. How Are Mental Disorders Conceptualized and Classified? • Mental Disorders Are Classified into Categories • Mental Disorders Must Be Assessed • Critical Thinking Skill: Recognizing When Categories Represent Continuous Dimensions • Dissociative Identity Disorder Is a Controversial Diagnosis • Mental Disorders Have Many Causes

5. Learning Objectives Differentiate among common methods for assessing mental disorders. Describe different theoretical models that seek to explain the etiology of mental disorders.

6. How Are Mental Disorders Conceptualized and Classified? • Historical treatment of those suffering from psychological disorders was frequently harsh, ineffective, or inadequate: • The Genain quadruplets • Conceptualizations of what causes such disorders has evolved from supernatural explanations to an understanding of the biological, social, and psychological factors that interact to produce such disorders

7. Mental Disorders Are Classified into Categories • There are clear advantages to categorizing disorders such as being able to investigate etiology and treatment • Emil Kraepelin provided one of the first diagnostic systems

8. Mental Disorders Are Classified into Categories • Currently, the DSM is used to categorize disorders using a multiaxial system: • Clinical disorders • Mental retardation or personality disorders, • Medical conditions • Psychosocial problems • Overall assessment of how well the person is functioning

10. Mental Disorders Must Be Assessed • Assessment refers to the process of examining a person’s mental functions and psychological health • Allows for a diagnosis to be made • Ongoing assessment can assist in understanding the effectiveness of treatment, situations that might trigger relapse, and improved understanding of the disorder

11. Mental Disorders Must Be Assessed • A mental status exam may be used to evaluate personal grooming, ability to make eye contact, tremors or twitches, mood, speech, thought content, and memory

12. Clinical psychologists examine a person’smental functions and psychological health todiagnose a mental disorder.

13. Mental Disorders Must Be Assessed • Structured vs. unstructured interviews: • The clinical interview is the most common assessment tool • Allowing interviewers to express empathy, build rapport, and discover the nature of the client’s problem • Interviews can be structured or unstructured, with more structured interviews reporting higher reliability • Structured Clinical Interview for DSM

14. Mental Disorders Must Be Assessed • Types of testing: • Behavioral assessment includes observations of individuals in a variety of settings and psychological testing: • Beck Depression Inventory • Minnesota Multiphasic Personality Inventory • Neuropsychological assessment allows for a determination of possible brain abnormalities

15. Mental Disorders Must Be Assessed • Evidence-based assessment: • Uses research to guide how mental disorders are evaluated including • Selecting appropriate psychological tests • Using appropriate neuropsychological methods • Using critical thinking in making a diagnosis

16. As this diagram illustrates, mental disorders commonlyoverlap.

17. Critical Thinking Skill • Recognizing when categories represent continuous dimensions • Most dimensions in life do not represent absolute differences • It is important to recognize when things fall onto a continuum

18. It may seem obvious that a person at point A is not anxious and a person at point C is anxious, but how should a person at point B be classified?

19. Dissociative Identity Disorder Is a Controversial Diagnosis • DID is a controversial diagnosis • Billy Milligan • According to the most common theory of DID: • Children cope with abuse by pretending that it is happening to someone else • They dissociate their mental states from their physical bodies • Most people diagnosed with DID are women who report being severely abused as children

20. Dissociative Identity Disorder Is a Controversial Diagnosis • Before the 1980s, there were only sporadic reports of this disorder • It has been suggested that the huge increase in the number of DID cases was due to therapists who used hypnosis to discover traumatic events from the patient’s childhood, and might have suggested DID symptoms to the patients they were assessing

21. Mental Disorders Have Many Causes • Diathesis-stress model • Disorders are caused by an underlying vulnerability or predisposition (known as diathesis) to a mental disorder that is triggered by stress • The diathesis can be biological, such as a genetic predisposition to a specific disorder, or environmental, such as childhood trauma

22. In this model, nature and nurture work together: A person can be vulnerable to a mental disorder because of an inherited predisposition, an environmental influence, or both. Stress then may act upon the person’s vulnerability.

23. Mental Disorders Have Many Causes • Biological factors: • Comparing mental disorders between identical and fraternal twins and studying individuals who have been adopted reveal the importance of genetic factors to the development of mental disorders

24. Mental Disorders Have Many Causes • Toxins: • Some mental disorders may arise from prenatal problems such as maternal illness, malnutrition, and exposure to toxins • Environmental toxins and malnutrition during childhood and adolescence can increase the risk for mental disorders

25. Mental Disorders Have Many Causes • Structural imaging, PET, and fMRI have revealed differences in brain anatomy between those with mental disorders and those without • May be due to genetics • The role of neurotransmitters has also been explored

26. Mental Disorders Have Many Causes • Psychological factors: • Freud believed that mental disorders were mostly due to unconscious conflicts • Thoughts and emotions are shaped by the environment and can profoundly influence behavior • Family systems model • Sociocultural model

27. Mental Disorders Have Many Causes • Cognitive-behavioral factors: • Thoughts can become distorted and produce maladaptive behaviors and emotions • One way of categorizing mental disorders is to divide them into two major groups: • Internalizing disorders • Externalizing disorders

28. Mental Disorders Have Many Causes • Sex differences in mental disorders: • Disorders associated with internalizing are more prevalent in females • Disorders associated with externalizing are more prevalent in males

29. In this graph, males are set as the baseline of 1 for comparison purposes.

30. Mental Disorders Have Many Causes • Culture and mental disorders: • Most mental disorders show both universal and culture-specific symptoms • They may be very similar around the world, but at the same time, they reflect cultural differences

31. Internalizing is more prevalent in females, and externalizing is more prevalent in males.

33. Can Anxiety Be the Root of Seemingly Different Disorders? • There Are Different Types of Anxiety Disorders • Anxiety Disorders Have Cognitive, Situational, and Biological Components

34. Learning Objectives Identify common symptoms experienced by people with anxiety disorders. Provide evidence supporting the cognitive, situational, and biological underpinnings of anxiety disorders.

35. There Are Different Types of Anxiety Disorders • More than 25% of people will experience an anxiety disorder • Different anxiety disorders share some emotional, cognitive, somatic, and motor symptoms • Despite similar symptoms, the behavioral manifestations of these disorders are quite different

36. There Are Different Types of Anxiety Disorders • Phobic disorder: • Specific phobias involve particular objects or situations • Social phobia involves fear of being humiliated in a social situation

38. Social phobia is comorbid with many other psychological disorders, all of which need to be considered to make a correct diagnosis.

39. There Are Different Types of Anxiety Disorders • Generalized anxiety disorder: • In generalized anxiety disorder, the anxiety experienced is more diffuse and general • Constant worrying

40. There Are Different Types of Anxiety Disorders • Panic disorder: • Those suffering from panic disorder experience sudden, overwhelming attacks of terror • May progress to agoraphobia, in which they are afraid of being in a situation where escape is impossible • Leading them to restrict their activities

41. There Are Different Types of Anxiety Disorders • Obsessive-compulsive disorder: • A person experiences repeated intrusive thoughts or images (obsessions) • Or the person feels compelled to engage in ritualistic behavior (compulsions)

42. Anxiety Disorders Have Cognitive, Situational, and Biological Components • When presented with ambiguous or neutral situations: • Anxious individuals tend to perceive them as threatening • Focus excessive attention on perceived threats • Nonanxious individuals assume that they are nonthreatening

43. Anxiety Disorders Have Cognitive, Situational, and Biological Components • Situational factors such as observation of anxiety in others or biological factors such as an inhibited temperament also work together to develop anxiety disorders

44. Anxious individuals tend to perceive ambiguous situations as threatening.

46. Anxiety Disorders Have Cognitive, Situational, and Biological Components • OCD: • People are aware that their obsessions and compulsions are irrational and yet they are unable to stop them • One explanation is that the disorder results from conditioning

47. Anxiety Disorders Have Cognitive, Situational, and Biological Components • Biological components: • Most likely involving a genetic factor focused on the neurotransmitter glutamate and the caudate nucleus • Streptococcal infection can cause a severe form of OCD in some young children, possibly due to damage to the caudate nucleus

48. Classical conditioning (here, step 1) and operant conditioning (steps 2–3) may contribute to a person’s developing OCD (step 4).

50. Are Mood Disorders Extreme Manifestations of Normal Moods? • There Are Different Types of Mood Disorders • Mood Disorders Have Cognitive, Situational, and Biological Components