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PSYCHOLOGICAL DISORDERS/

LECTURE OPENER SUGGESTIONS:Opening quotes:

Madness need not be all breakdown. It may also be break-through. R.D. Laing (1927-1982).You shall know the truth and the truth shall make you mad. Aldous Huxley (1894-1963)

Opening artwork:Vincent Van Gogh (1853-1890) Corridor in the Asylum, 1889

Portrait of Van Gogh Henri Toulouse-Lautrec (1864-1901)

OPENING THEMES:For many students, the topic of abnormal psychology represents the high point of the course;what they have been waiting to learn all semester. Therefore, engaging student interest in the

topic should not be a problem at all. The challenge is choosing the topics to focus on in this very

rich area of content. Working within the structure of the perspectives in psychology will make

this content easier for students to grasp, because the basic parameters have already been laiddown and developed in other chapters. Thus, presenting the possible causes for psychological

disorders should be done in terms of those perspectives. In terms of presenting the disorders, it iscrucial to emphasize the role of DSM-IV-TR (the most recent version) in setting the stage forreliable diagnoses. DSM-IV-TR also provides a good organizing structure to use in presenting

the disorders. Although there will not be time to devote sufficient attention to all disorders, you

should be able to focus on one or two that are of particular interest to you to use in helpingstudents gain a conceptualization of disorders as having multiple causes (and, in the next

chapter) multiple approaches to treatment.

KEY CONCEPTS

Historical perspectives

Definitions of abnormality

Models of abnormal behavior

DSM-IV-TR

Anxiety disorders

Somatoform disorders

Dissociative disorders

Mood disorders

Schizophrenia

Personality disorders

Prologue: Chris Coles

Looking AheadMODULE 37: NORMAL VERSUS ABNORMAL: MAKING THE DISTINCTIONDefining AbnormalityIdentifying Normal and Abnormal Behavior: Drawing the Line on PsychologicalDisordersPerspectives on Abnormality: From Superstition to ScienceThe Medical PerspectiveThe Psychoanalytic PerspectiveThe Behavioral PerspectiveThe Cognitive Perspective

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The Humanistic PerspectiveThe Sociocultural PerspectiveClassifying Abnormal Behavior: The ABCs of DSMDSM-IV-TR: Determining Diagnostic DistinctionsConning the Classifiers: The Shortcomings ofDSM-IV-TR

How can we distinguish normal from abnormal behavior?What are the major perspectives on psychological disorders used by mental

health professionals?What classification system is used to categorize psychological disorders?

Applying Psychology in the 21st Century Suicide Bombers: Normal or Abnormal?

Learning Objectives:37-1 Discuss the various approaches to defining abnormal behavior.

37-2 Describe and distinguish the various perspectives of abnormality, and apply thoseperspectives to specific mental disorders.

37-3 Describe theDSM-IV-TR and its use in diagnosing and classifying mental disorders.

Student Assignments:Interactivity 61:DSM-IV-TR

Students answer questions about theDSM-IV-TR organization and usage.

Views on Psychological Disorders

Have students complete Handout 12-1, a survey of views on psychological disorders.

Perspectives on Abnormality

Ask students the following questions:1. How does the medical perspective of abnormality compare with the behavioral

neuroscience perspective in psychology? How are they the same and how are they

different?2. If you were a mental health professional, how would you integrate the best of each

perspective in treating your clients?

3. Which perspective is theDSM-IV-TR most closely associated with?

Library Research on theDSM-IV-TR

Send students to the library (or other source) to look at theDSM-IV-TR. Ask them thesequestions:

1. How do you feel about the idea of categorizing psychological disorders as is done in the

DSM-IV-TR?

2. What was the scientific basis for theDSM-IV-TR?

3. How does theDSM-IV-TR differ from earlierDSMs?4. What do you think is the most intriguing disorder in theDSM-IV-TR?

Lecture Ideas:Summary of History of Mental Illness:

Prehistoric times:

Demonic possession was thought to cause psychological disorders. Based on evidence of

trephined skulls, it was thought that prehistoric people tried to release the evil spirits by drilling ahole in the skull.

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Ancient Greece and Rome:

The scientific approach emerged. The Greek physician Hippocrates sought a cause within the

body. This approach continued through Roman times with the writings of the physician Galen.

Middle Ages:

Return to belief in spiritual possession and attempts to exorcise the devil out of the mentally ill.

The mentally ill were thrown into prisons and poorhouses.

Renaissance:

First hospital to house the mentally ill was builtSt. Marys Hospital in Bethlehem (London).Attempts to provide more humane treatment.

Witch hunts took place starting in the 1500s and continued through the 1700s.

1700s:

Asylums again became overcrowded and conditions deteriorated. By the 1700s, St. Marys wasknown as bedlam.

1800s:

Reform movements began in Europe and the United States:

Benjamin Rush attempted to devise new methods of treatment (the tranquilizing chair)

based on scientific method.

Dorothea Dix, a Massachusetts schoolteacher, originated the state hospital movement as ameans of providing moral treatment.

Early to mid 20th century:Overcrowding again became prevalent in state mental hospitals. Extreme measures of treatment

were used that were thought by many to be inhumane.

Era of deinstitutionalizationlate 20th century:

Invention of antipsychotic medications in the 1950s made it possible for people with severe

disorders to live outside institutions. President Kennedy called for community mental health

centers. However, this has not been completely effective as the problem of homelessness hasarisen.

The Insanity Defense (from Pettijohns Connectext)

As discussed in the text, it is difficult to define abnormal behavior. The issue becomes even more

complicated when questions are raised in a court of law about a defendants mental condition at

the time he or she is alleged to have committed a crime. When the defendant pleads not guilty

by reason of insanity, the court must assess his or her mental condition. The issue of insanity isdecided by a judge or jury after listening to testimony of experts, who are usually psychologists

or psychiatrists.It is important to remember that in a court, the concept of insanity is legal rather than

psychological. The insanity plea is used in situations where the defendant is judged to be

incapable of knowing right from wrong because of a mental disorder. Although psychologists

may examine the individual and testify in court, the final decision is a legal one, made by thecourts based on legal precedent.

As you are probably aware, even the experts are not in agreement over insanity as a

legitimate defense. In some cases, insanity is used as a means to avoid prosecution. Normally, if

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one is judged insane, he or she is committed to a mental hospital until cured. If later judged sane,

he or she is set free, sometimes after only a light sentence. One proposal is to replace the verdictof not guilty by reason of insanity with the verdict of guilty but mentally ill. Individuals

found guilty but mentally ill would be given the proper psychotherapy to treat their mental

disorders, and when they were judged sane, they would be returned to prison to complete theirsentences.

A related issue is the ability of the defendant to stand trial. In order to be brought to trial,

an individual must understand the charge against him or her and be able to prepare a proper

defense with a lawyer. Many times, instead of standing trial, the defendant is judgedincompetent to stand trial and is committed to a mental institution for treatment. After being

confined for a period of time, he or she is released if judged competent. Unfortunately, it is

difficult to predict the future behavior of such a person. More research needs to be conducted onthe application of psychological determinations to legal proceedings.

Madness and Creativity: The Case of Vincent Van Gogh

The case of Vincent van Gogh (1853-1890) provides an excellent opportunity to discuss the

relationship between madness and creativity. Van Gogh is generally considered the greatest

Dutch painter after Rembrandt. His reputation is based largely on the works of the last threeyears of his short, 10-year painting career, and he had a powerful influence on expressionism in

modern art. He produced more than 800 oil paintings and 700 drawings, but he sold only oneduring his lifetime. His striking colors, coarse brushwork, and contoured forms display the

anguish of the mental illness that drove him to suicide.

Illustrate his case with examples of his late art works, completed while he was a patient at the

asylum in St. Remy.

Discuss the diagnoses that have been ascribed to Van Gogh over the years. They are as follows:

1. Epilepsy2. Schizophrenia

3. Suppressed form of epilepsy

4. Episodic twilight states5. Epileptoid psychosis

6. Psychopathy

7. Psychosis of degeneration

8. Schizoform reaction9. Cerebral tumor

10. Active luetic schizoid and epileptoid disposition

11. Phasic schizophrenia12. Dementia praecox

13. Meningo-encephalitis luetica

14. Psychotic exhaustion caused by creative effort

15. Atypical psychosis heterogeneously compounded of elements of epileptic and schizoiddisposition.

16. Phasic hallucinatory psychosis.

17. Neurasthenia18. Chronic sunstroke and the influence of yellow.

19. Psychomotor epilepsy

20. Dromomania21. Maniacal excitement

22. Turpentine poisoning

23. Hypertrophy of the creative forces

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24. Acute mania with generalized delirium

25. Epileptic crises and attacks of epilepsy26. Glaucoma

27. Frontotemporal dementia

28. Xanthopsia caused by digitalis (as treatment for mania)seeing the world through ayellow haze.

Numerous web sites discuss Van Goghs condition and possible diagnoses;

http://www.psych.ucalgary.ca/PACE/VA-Lab/AVDE-Website/VanGogh.htmlhttp://www.uchsc.edu/news/bridge/2003/jan1/art1.html

Most recently, this diagnosis was published in The American Journal of Psychiatry:

Vincent van Gogh (1853-1890) had an eccentric personality and unstable moods, suffered from

recurrent psychotic episodes during the last 2 years of his extraordinary life, and committed

suicide at the age of 37. Despite limited evidence, well over 150 physicians have ventured aperplexing variety of diagnoses of his illness. Henri Gastaut, in a study of the artists life and

medical history published in 1956, identified van Goghs major illness during the last 2 years of

his life as temporal lobe epilepsy precipitated by the use of absinthe in the presence of an early

limbic lesion. In essence, Gastaut confirmed the diagnosis originally made by the French

physicians who had treated van Gogh. However, van Gogh had earlier suffered two distinct

episodes of reactive depression, and there are clearly bipolar aspects to his history. Both episodes

of depression were followed by sustained periods of increasingly high energy and enthusiasm,

first as an evangelist and then as an artist. The highlights of van Goghs life and letters are

reviewed and discussed in an effort toward better understanding of the complexity of his illness.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?

cmd=Retrieve&db=PubMed&list_uids=11925286&dopt=AbstractBlumer, D. (2002). The illness of Vincent Van Gogh.American Journal of Psychiatry, 159,

519-526.

The Medical Perspective: Genes and Depression

NIMH Report: Gene More Than Doubles Risk of Depression Following LifeStresses

Among people who suffered multiple stressful life events over 5 years, 43 percent with one

version of a gene developeddepression, compared to only 17 percent with another version of the

gene, say researchers funded, in part, by the National Institute of Mental Health (NIMH). Thosewith the short, or stress-sensitive, version of the serotonin transporter gene were also at higher

risk for depression if they had been abused as children. Yet no matter how many stressful life

events they endured, people with the long, or protective, version experienced no more

depression than people who were totally spared from stressful life events. The short variant

appears to confer vulnerability to stresses, such as loss of a job, breaking up with a partner, deathof a loved one, or a prolonged illness, report Drs. Avshalom Caspi and Terrie Moffitt, University

of Wisconsin and Kings College London, and colleagues, in the July 18, 2003, Science.

The serotonin transporter gene codes for the protein in neurons, brain cells, that recycles the

chemical messenger after its been secreted into the synapse, the gulf between cells. Since themost widely prescribed class of antidepressants act by blocking this transporter protein, the gene

has been a prime suspect in mood and anxiety disorders. Yet, its link to depression eluded

detection in eight previous studies.

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We found the connection only because we looked at the study members stress history, noted

Moffitt. She suggested that measuring such pivotal environmental eventswhich can includeinfections and toxins as well as psychosocial traumasmight be the key to unlocking the secrets

of psychiatric genetics.

Although the short gene variant appears to predict who will become depressed following life

stress about as well as a test for bone mineral density predicts who will get a fractured hip after a

fall, its not yet ready for use as a diagnostic test, Moffitt cautioned. If confirmed, it may

eventually be used in conjunction with other, yet-to-be-discovered genes that predispose fordepression in a gene array test that could help to identify candidates for preventive

interventions. Discovering how the long variant exerts its apparent protective effect may also

lead to new treatments, added Moffitt.

Everyone inherits two copies of the serotonin transporter gene, one from each parent. The two

versions are created by a slight variation in the sequence of DNA in a region of the gene that actslike a dimmer switch, controlling the level of the genes turning on and off. This normal genetic

variation, or polymorphism, leads to transporters that function somewhat differently. The short

variant makes less protein, resulting in increased levels of serotonin in the synapse andprolonged binding of the neurotransmitter to receptors on connecting neurons. Its transporter

protein may thus be less efficient at stopping unwanted messages, Moffitt suggests.

Moffitt and colleagues followed 847 Caucasian New Zealanders, born in the early l970s, from

birth into adulthood. Reflecting the approximate mix of the two gene variants in Caucasian

populations, 17 percent carried two copies of the stress-sensitive short version, 31 percent two

copies of the protective long version, and 51 percent one copy of each version.

Based on clues from studies in knockout mice, monkeys, and functional brain imagingin

humans, the researchers hypothesized that the short variant predisposed for depression via agene-by-environment interaction. They charted study participants stressful life events

employment, financial, housing, health and relationship woesfrom ages 21 to 26. These

included debt problems, homelessness, a disabling injury, and being an abuse victim. Thirty

percent had none, 25 percent one, 20 percent two, 11 percent three, and 15 percent four or moresuch stressful life experiences. When evaluated at age 26, 17 percent of the participants had a

diagnosis of major depression in the past year and three percent had either attempted or thought

about suicide.

Although carriers of the short variant who experienced four or more life stresses represented only

10 percent of the study participants, they accounted for nearly one quarter of the 133 cases ofdepression. Among those with four or more life stresses, 33 percent with either one or two copies

of the short variantand 43 percent of those with two copies of the short variantdeveloped

depression, compared to 17 percent of those with two copies of the long variant.

The stressful life events led to onset of new depression among people with one or two copies of

the short gene variant who didnt have depression before the events happened. The events failedto predict a diagnosis of new depression among those with two copies of the long variant.

Among those who had experienced multiple stressful events, 11 percent with the short variant

thought about or attempted suicide, compared to 4 percent with two copies of the long variant.

These self-reports were corroborated by reports from participants loved ones.

The researchers suggest that effects of genes in complex disorders like psychiatric illnesses are

most likely to be uncovered when such life stresses are measured, since a genes effects mayonly be expressed, or turned on, in people exposed to the requisite environmental risks.

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http://www.nimh.nih.gov/events/prgenestress.cfm

TheDSM-IV-TR

Summarize the 5 axes of theDSM-IV-TR:

(an axis is a diagnostic dimension)1. Primary disordersyndromes, like illnesses

2. Long-standing personality problems

3. Physical disorders or illnesses

4. Severity of stressors5. Level of functioning over past year

Summarize the assumptions of theDSM-IV-TR:

descriptive

need for standardized language

Present two areas of criticism of theDSM-IV-TR:

descriptive

dimensional ratings may be preferable

Media Presentation Ideas:Media Resources DVD: History of Mental Illness (6:01)

Outstanding video presenting a summary of beliefs about the causes of psychological disordersfrom ancient times to the present.

Media Resources DVD: Alcohol Addiction (6:25)

Show this segment to illustrate the role of the brain in psychological disorders involving

substance abuse.

Media Resources DVD: Freuds Contribution to Psychology (3:28)Show this segment, which provides a summary of Freuds theory and a reenactment of his methods oftreatment.

Slide Show: Vincent Van GoghOn PowerPoint, display a collection of images from the latter years of Van Goghs life, at the same time

playing the song Vincent by Don McLean. This is a very effective way to begin a discussion of Van

Goghs art and madness.

The Vincent Van Gogh museum online can be found at:

http://www.vangoghgallery.com/painting/main_az.htm

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Overhead: Historical Perspectives on Abnormality

Historical Views on Treatment of Mental Disorders

Time

Reformer

Technique

Purpose

Stone Ages

Trephining

Drill hole in head to let evil spirits out of the body

Fourth Century B.C.

Hippocrates(460-377 B.C.)

Rest, exercise, abstinence from alcohol and sex

Restore balance of fluids, or humors, in body

Fifteenth Century

Exorcism, torture, hangingRelease evil spirits

Eighteenth CenturyPhilippe Pinel

(1745-1826)

Reform at Bicetre Asylum in Paris, released patients from chains, classified different types ofpsychological disturbances

Restore humanity to patients

Nineteenth Century

Dorothea Dix

(1802-1887)

Separated mentally ill from prisoners, established state mental hospital systemGive good care

Twentieth CenturyClifford Beers

(1876-1943)

National Committee for Mental Hygiene (1909), research

Improve conditions in mental hospitals

Eclectic orientation of therapists

Return patients to society

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Popular Movie: Historical Perspectives on AbnormalityOne Flew Over the Cuckoos Nest is the classic depiction of life in a psychiatric hospital in the late

1950s, when ECT was used as punishment.

Overhead: Genetic Contributions to DepressionFrom the NIMH web sites description of the 2003 study on genes and depression, show this overhead:

(http://www.nimh.nih.gov/events/prgenestress.cfm)

Overhead: Heritability of Schizophrenia

This overhead provides support for genetic contributions to schizophrenia by showing the higher

concordance rates with increasing familial relationships.

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MODULE 38: THE MAJOR PSYCHOLOGICAL DISORDERSAnxiety Disorders

Phobic DisorderPanic DisorderGeneralized Anxiety DisorderObsessive-Compulsive DisorderThe Causes of Anxiety Disorders

Somatoform DisordersDissociative DisordersMood Disorders

Major DepressionMania and Bipolar DisordersCauses of Mood Disorders

SchizophreniaSolving the Puzzle of Schizophrenia: Biological CausesEnvironmental Perspectives on SchizophreniaThe Multiple Causes of Schizophrenia

Personality Disorders

Childhood DisordersFurther Disorders

What are the major psychological disorders?

Learning Objectives:38-1 Describe the anxiety disorders and their causes.38-2 Describe the somatoform disorders and their causes.

38-3 Describe the dissociative disorders and their causes.

38-4 Describe the mood disorders and their causes.38-5 Describe the types of schizophrenia, its main symptoms, and the theories that account for

its causes.38-6 Describe the personality disorders and their causes.

Student Assignments:Interactivity 62: Schizophrenia Symptoms

Students watch a brief video of an interview with a client who has schizophrenia and answer

questions about the clients symptoms and other features of the disorder.

Interactivity 63: Bipolar Disorder Symptoms

Students watch a brief video of an interview with a client who has bipolar disorder and answer

questions about the clients symptoms and other features of the disorder.

Interactivity 64: Agoraphobia Symptoms

Students watch a brief video of an interview with a client who has agoraphobia and answerquestions about the clients symptoms and other features of the disorder.

Interactivity 65: Borderline Symptoms

Students watch a brief video of an interview with a client who has bipolar personality disorderand answer questions about the clients symptoms and other features of the disorder.

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Perspectives on Specific Disorders

Ask students the following questions:Choose the psychological disorder that is of greatest interest to you and answer these questions:

1. State which disorder it is and summarize its diagnostic criteria.

2. Explain why this disorder is considered abnormal behavior.3. Compare two approaches to understanding this disorder (such as biological vs.

sociocultural) and state which approach you prefer (and why).

Abnormal Psychology in the MediaHave students complete Handout 12-2 on representations of abnormality in the popular media.

Movie Depictions of Psychological Disorders

Ask students the following questions:

1. Describe a movie character who you think is a good example of a psychological disorder.

2. What disorder does this character represent? Why?3. Do you think that the movie did a good job or a bad job of depicting this disorder? Why?

4. What impact do you think that movies can have on how people feel about psychological

disorders?

PowerWeb: SchizophreniaThe Schizophrenic Mind, Sharon Begley,Newsweek, March 11, 2002.

Recent movies and cases in criminal courts have brought the baffling illness schizophrenia to ourattention. This article discusses what schizophrenia is and how it can be treated.

Lecture Ideas:Summary of Disorders

Provide brief summaries of the major disorders and their symptoms using the following guide:

Major Diagnostic Categories:

Use Figure 38-2 to provide an overview of the major disorders covered in the text.

Anxiety disorders:

Phobic disorder (specific phobia)intense and irrational fears.

Panic disordersense of impending doom

Generalized anxiety disorderlong-term consistent anxiety resulting in physiological

problems

Obsessive-compulsive disorderobsessions are recurring, irrational thoughts

compulsions are repetitive, purposeless behaviors.

(Note: Social Phobia is not covered)

Somatoform disorders:

Two major forms of somatoform disorder are:

Hypochondriasisconstant fear of illness and physical sensations interpreted as signs of

disease.

Conversion disorderphysical disturbance with psychological cause.

Dissociative disorders:

Dissociative identity disorderformerly called multiple personality disorder, involves

several alters and a host personality.

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Dissociative amnesiaforgetting of personal events with no physiological cause.

Dissociative fugueentering into an altered state of behavior or actions.

Mood disorders:

Major depressive disorder: Unusually sad mood along with physiological symptoms,

feelings of guilt, low self-esteem, and suicidality.

Bipolar disorder (formerly manic depression): at least one period of mania, involving

euphoria; may alternate with period of depressed mood.

Schizophrenia

Decline from previous level of functioning

Disturbances of thought and language

Delusions (false beliefs)

Hallucinations (false perceptions)

Emotional (affective) disturbance

Withdrawal

[In addition to these symptoms, there are five subtypes of schizophrenia (see Figure 38-7)]

Personality Disorders:Symptoms:

Little personal distress

May lead seemingly normal lives

Rigid, inflexible maladaptive personality traits

Three types discussed in text:

Antisocial personality disorderimpulsiveness, criminal behavior, lack of remorse.

Borderline personality disorderinstability of self and relationships.

Narcissistic personality disorderextreme preoccupation with ones own appearance,

needs, and concerns.

Forms of Specific Phobia

Below are some of the less common but interestingly named phobias. See how many yourstudents can guess (knowledge of Latin helps!!). Be careful, though, not to make fun of any of

these phobias, as some students may actually have one of these, though the odds are low.

More phobias can be found on this unauthorized but entertaining web site:

http://www.phobialist.com/

AblutophobiaFear of washing or bathing

AerophobiaFear of swallowing airAmbulophobiaFear of walking

AnablephobiaFear of looking upAnemophobiaFear of wind

AnthrophobiaFear of flowers

ArachibutyrophobiaFear of peanut butter sticking to the roof of the mouth.ArithmophobiaFear of numbers

AulophobiaFear of flutes

AuroraphobiaFear of Northern Lights

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BarophobiaFear of gravity

BasophobiaFear of walkingBatophobiaFear of being close to high buildings

BibliophobiaFear of books

BlennophobiaFear of slimeBogyphobiaFear of the bogeyman

CathisophobiaFear of sitting

CatoptrophobiaFear of mirrors

ChaetophobiaFear of hairChionophobiaFear of snow

ChromatophobiaFear of colors

ChronophobiaFear of timeChronomentrophobiaFear of clocks

CibophobiaFear of food

ClinophobiaFear of going to bedCnidophobiaFear of string

DeciophobiaFear of making decisions

DendrophobiaFear of treesDextrophobiaFear of objects at the right side of the body

DidaskaleinophobiaFear of schoolEisoptrophobiaFear of mirrors

EleutherophobiaFear of freedomEosophobiaFear of daylight

EpistemophobiaFear of knowledge

ErgophobiaFear of workEreuthophobiaFear of the color red

GeliophobiaFear of laughter

GeniophobiaFear of chinsGenuphobiaFear of knees

GeumaphobiaFear of taste

GnosiophobiaFear of knowledgeGraphophobiaFear of writing

HeliophobiaFear of the sun

HelmintophobiaFear of being infested with worms

HemophobiaFear of bloodHippopotomonstrosesquippedaliophobiaFear of long words

HomichlophobiaFear of fog

HypnophobiaFear of sleepIchthyophobiaFear of fish

IdeophobiaFear of ideas

KainophobiaFear of anything new

KathisophobiaFear of sitting downLachanophobiaFear of vegetables

LeukophobiaFear of the color white

LevophobiaFear of objects to the left side of the bodyLinonophobiaFear of string

LogophobiaFear of words

MelanophobiaFear of the color blackMelophobiaFear of music

MetrophobiaFear of poetry

MnemophobiaFear of memories

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MottephobiaFear of moths

NebulaphobiaFear of fogNeophobiaFear of anything new

NephophobiaFear of clouds

NomatophobiaFear of namesOctophobiaFear of the number 8

OmmetaphobiaFear of eyes

OneirophobiaFear of dreams

OphthalmophobiaFear of opening ones eyesOstraconophobiaFear of shellfish

PanophobiaFear of everything

PapyrophobiaFear of paperParaskavedekatriaphobiaFear of Friday the 13th

PeladophobiaFear of bald people

PhengophobiaFear of daylightPhobophobiaFear of fear

PhotophobiaFear of light

PhronemophobiaFear of thinkingPogonophobiaFear of beards

SciophobiaFear of shadowsScolionophobiaFear of school

SelenophobiaFear of the moonSiderophobiaFear of stars

SitophobiaFear of food

SophophobiaFear of learningStasibasiphobiaFear of walking

ThaasophobiaFear of sitting

TrichopathophobiaFear of hairTriskadekaphobiaFear of the number 13

VerbophobiaFear of words

XanthophobiaFear of the color yellow

Physician-Assisted SuicideRelationship to Major Depressive Disorder (from Pettijohns

Connectext)

The right of a terminally ill person to commit suicide with the assistance of a physician is

currently a controversial issue in the United States. Suicide is often considered an abnormal

behavior that should be prevented at all costs. There are suicide telephone hot-lines dedicated topersuading individuals from committing this act. Can suicide be viewed as a normal, rational

behavior? Perhaps the strongest case could be made for terminally ill patients who experience

extreme pain (Humphry, 1992).

Many people now write living wills that dictate treatments to be given or refused in theevent of a terminal illness. If a terminally ill person refuses treatment, this might be considered a

type of passive suicide. More controversial is the situation in which a terminally ill person will

not immediately die, but will have to endure a long period of pain and suffering. One alternativeto this situation is assisted suicide, in which the individual is helped in the suicide by a

physician. For the past decade, Jack Kevorkian, a Michigan retired pathologist, has been actively

involved in assisted suicides and has lobbied to make assisted suicide legal for mentallycompetent individuals.

Opponents argue that potential suicide victims are not mentally competent. Indeed, many

terminally ill patients become severely depressed prior to accepting their situation. It is generally

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assumed that depressed patients are not rational about suicide. Some people also voice concerns

that if assisted suicide is sanctioned, there will be more pressure for the elderly to end their livesprematurely. Someone might not want to be a burden on others, or might believe that relatives

dont want them around. The assisted suicide debate involves legal, medical, and psychological

issues. The solution will not be easy, but will need the cooperation and understanding of manydifferent factions.

Reference

Humphry, D. (1992). Rational suicide among the elderly. Suicides and Life-ThreateningBehavior, 22, 125-129.

Media Presentation Ideas:Media Resources DVD: Beautiful Minds: An Interview with John Nash and Son (8:40)

An interview with Nobel prizewinning mathematician John Nash and son provides insight into

the experience of schizophrenia.

Media Resources DVD: Symptoms of Schizophrenia (3:35)

Brief interview with a schizophrenic patient.

Media Resources DVD: Depression: Theories and Treatments (4:02)

Examines the causes of and medications for depression.

Media Resources DVD: Bipolar Disorder (4:34)

Case example of a man with bipolar disorder; includes methods of brain imaging.

Media Resources DVD: Dysthymia (1:44)

Interview of a patient with dysthymia.

Media Resources DVD: PTSD (3:25)

Interview of a patient with PTSD.

Popular Movies and Television Shows

The following are a list of films that portray characters with psychological disorders:

Fatal Attraction: Borderline personality disorder

As Good as it Gets; Matchstick Men: Obsessive-compulsive disorderIris: Alzheimers Disease

A Beautiful Mind: Schizophrenia (Media Resources has interview with Nash)

Pollack: Depression (and alcohol abuse)

Chicago: Antisocial personality disorder in females (very unusual!)King of Hearts: Mental illness and society

Vertigo: Anxiety disorder (acrophobia)Benny and Joon: SchizophreniaWhat About Bob: Borderline personality disorder

Fisher King: Schizophrenia

Girl Interrupted: Borderline personality disorder (and/or depression)Gone With the Wind: Histrionic personality disorder

Heavenly Creatures: Shared psychotic disorder

The Hours: Major depressive disorderI Am Sam: Mental retardation

Memento: Amnestic disorder

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Sybil: Dissociative identity disorder

Nurse Betty: Dissociative fugueRain Man: Autistic disorder

Single White Female: Borderline personality disorder

The Virgin Suicides: Depression in teens

The television program ER provided an excellent example of bipolar disorder in the character

of Abbys (the nurse) mother, played by Sally Field.

Forms of Phobia

Show these terms and clip art illustrations for a variety of types of phobias:

Panic Disorder Panic attacks occur without a

specific trigger or stimulus

Agoraphobia Fear of being in a situation in

which escape is difficult, andin which help for a possible

panic attack would not be

availableAilurophobia Fear of cats

Arachnophobia Fear of spiders

Cynophobia Fear of dogs

Equinophobia Fear of horses

Insectophobia Fear of insects

Ophidiophobia Fear of snakes

Rodentophobia Fear of rodents

Acrophobia Fear of heights

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Brontophobia Fear of thunder

Claustrophobia Fear of small, enclosed spaces

Mysophobia Fear of dirt

Nyctophobia Fear of darkness

MODULE 39: PSYCHOLOGICAL DISORDERS IN PERSPECTIVE

The Prevalence of Psychological Disorders: The Mental State of theUnionThe Social and Cultural Context of Psychological Disorders

How prevalent are psychological disorders?What indicators signal a need for the help of a mental health practitioner?

Exploring Diversity DSM and Cultureand the Culture of DSMBecoming an Informed Consumer of Psychology Deciding When You Need Help

Learning Objectives:

39-1 Discuss the other forms of abnormal behavior described in theDSM-IV, the prevalence ofpsychological disorders, and issues related to seeking help. (pp. 495498)

Student Assignments:Interactivity 66: Prevalence of Psychological Disorders

Students answer questions about the prevalence of major psychological disorders.

Web Research

Send students to the Surgeon Generals Report on Mental Health

http://www.surgeongeneral.gov/library/mentalhealth/home.html. This is an extensive web sitewith detailed information about the major psychological disorders. Give students instructions to

report on a disorder that they personally found to be the most interesting. Review briefly thesymptoms, causes, and prevalence of this disorder. Indicate how it differs among age-groups

(children, teens, adults, older adults). What are the prospects for the future of finding a cure forthis disorder?

Lecture Ideas:Surgeons General Report

As noted above, the Surgeon Generals Report contains a wealth of information(http://www.surgeongeneral.gov/library/mentalhealth/home.html). All material in this web site is

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in the public domain. Reproduce summaries, figures, and tables either as handouts or as lecture

overheads and slides.

Information on Mental Illness from NIMH

Extensive background information on mental illness can be found on this web site:http://www.nimh.nih.gov/publicat/index.cfm. This web site contains NIMH publications,

including overheads, statistics, professional publications, and information for the public.

Media Presentation Ideas:National Health Interview Survey (NHIS) Results

The NHIS tracks the health of Americans. These overheads summarize findings from the portion

of the survey concerning mental health (more details can be found at

http://www.cdc.gov/nchs/about/major/nhis/released200303.htm#13.)

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