Chapter 16: Abnormal Psychology

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Chapter 16 Abnormal Psychology
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• To study the abnormal is the best way of
  understanding the normal
• William James (1842-1910).
•  
• At various moments, all of us feel, think, or act
  the way disturbed people do much of the time we
  all get anxious, depressed, withdrawn,
  suspicious, or deluded, just less intensely and
  more briefly.
•  
• The World Health Organization (WHO) estimates
  that 450 million people worldwide suffer
  psychological disorders.

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• In order to help us figure out if behavior is
  abnormal, it helps to ask and answer 3 major
  questions
•  
• 1. How should we define psychological disorders?
•  
• 2. How should we understand psychological
  disorders? Biological sickness (nature) or result
  of environment (nurture)?
•  
• 3. How should we classify psychological
  disorders?

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1. Defining Disorders

• When behavior is deviant, distressful, and
  dysfunctional it is classified as a disorder.
•  
• It is important to remember that deviant behavior
  varies by culture and context nudity and the
  Nazis.
•  
• Psychological standards can also vary with time
  from 1952-1973, homosexuality was classified as
  an illness. One of todays biggest controversies
  revolves around ADHD (see Box on pg. 641).
•  

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• While deviance and distress are components of
  disorders, dysfunction is the key someone can
  act strangely or be in distress, but unless their
  behavior interferes with their normal
  functioning, it is not considered disordered.
•  
• An intense fear of spiders may be deviant, but is
  not a disorder.
• If you refuse to leave your house because there
  may be spiders outside, well
•  

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2. Understanding Disorders

• To explain puzzling behavior, people in earlier
  times often presumed that strange forces the
  movement of the stars, godlike powers, or evil
  spirits were at work.
•  
• By the 1800s, psychology took on a medical
  model mental illnesses are sicknesses, can be
  diagnosed through their symptoms, and can be
  cured through therapy.
•  
• The medical model has gained a great deal of
  support in recent decades thanks to the
  advancement of neuroscience and its associated
  technology.

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• Today, the biopsychosocial approach seems to be
  the most prevalent among psychologists this
  theory contends that all behavior (normal or
  disordered) arises from the interaction of nature
  (biological predisposition) and nurture (past and
  present experience).
•  
• Environmental factors can be seen in the
  occurrence of psychological disorders by culture
  schizophrenia is worldwide / anorexia and
  bulimia occur mostly in Western culture.
•  
• The biopsychosocial approach recognizes the mind
  and body as inseparable negative emotions can
  lead to physical illness and physical
  abnormalities contribute to emotional disorders.

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3. Classifying Disorders

• In all sciences, classification creates order
  by classifying disorders, we can quickly describe
  complex disorders. In psychiatry and psychology,
  diagnostic classification aims not only to
  describe a disorder but also to predict its
  future course.
•  
• In order to study a disorder, we must first name
  and describe it the current method for doing so
  is the American Psychological Associations
  Diagnostic and Statistical Manual of Mental
  Disorders (Fourth Edition), nicknamed the
  DSM-IV.
•  
• DSM-IV defines a diagnostic process and 16
  clinical syndromes. Without presuming to explain
  their causes, it describes various disorders and
  lists their prevalence (See Table 16.1 on pg.
  645).
•  
• DSM-IV guidelines are proven reliable (83).

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Labeling Psychological Disorders

• Critics fear that labeling psychological
  disorders can have a detrimental effect. Once we
  label a person, we view that person differently
  labels create preconceptions that guide our
  perceptions and our interpretations.
•  
• Rosenhans patient study (1973)
•  
• Pages rooms for rent (1977)
•  
• Unfortunately, mass media has created lasting
  images of psychological disorders the vast
  majority are not only unrealistic, but also
  inaccurate people with psychological disorders
  are more likely to be victims of crimes than they
  are to be perpetrators for crime.

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Anxiety Disorders

• Anxiety is a part of life we all feel anxious
  sometimes (tests, public speaking, the big game,
  the first date). Fortunately for most of us, our
  uneasiness is not intense and persistent.
• If it were to be, we may have one of the anxiety
  disorders psychological disorders characterized
  by distressing, persistent anxiety or maladaptive
  behaviors that reduce anxiety.
•  
• For now, we will focus on 4 types of anxiety
  disorders 
• 1. Generalized Anxiety Disorder 
• 2. Panic Disorder
• 3. Phobias
• 4. Obsessive-Compulsive Disorder

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1. Generalized Anxiety Disorder

• Tom, a 27-year-old electrician, complains of
  dizziness, sweating palms, heart palpitations,
  and ringing in his ears he often feels edgy and
  finds himself trembling that occasionally forces
  him to leave work his doctor can find no
  physical problems with him.
• Toms unfocused, out-of-control, negative
  feelings suggest generalized anxiety disorder
  anxiety disorder in which an individual is
  continually tense, apprehensive, and in a state
  of autonomic nervous system arousal.

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• While symptoms of this disorder are common,
  their persistence is not 2/3 with this
  condition are women, most are continuously tense
  and jittery, worried bad things may happen, and
  plagued by muscular tension, agitation, and
  sleeplessness.
• Concentration is often difficult as attention
  switches from one worry to another many times,
  the worst characteristics is that a person cannot
  identify its cause and therefore, cannot deal
  with it.
• Generalized anxiety disorder is often accompanied
  by depression and can lead to physical problems
  like headaches, ulcers, and high blood pressure.

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2. Panic Disorder

• Panic disorder an anxiety disorder marked by
  unpredictable minutes-long episodes of intense
  dread in which a person experiences terror and
  accompanying chest pain, choking, or other
  tightening sensations.
• Panic is to anxiety what a tornado is to a windy
  day it strikes suddenly, wreaks havoc, and
  disappears.
•  

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• Some individuals are prone to panic attacks
  the physical effects of which may be misperceived
  as a heart attack or some other serious physical
  ailment. So unpredictable and frightening is
  this false-alarm experience that after several
  attacks, people come to fear the fear itself and
  to avoid situations where panic has struck
  before.
• Agoraphobia is the fear or avoidance of
  situations in which escape might be difficult or
  unavailable when panic arrives given such fear,
  people may avoid being outside the home, in a
  crowd, on a bus, or even on an elevator.
•  
• Darwin _at_ 28

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3. Phobias

• Marilyn, a 28-year-old homemaker, is otherwise
  healthy and happy, but she so fears thunderstorms
  that she feels anxious as soon as a weather
  forecaster mentions possible storms later in the
  week. During a storm, she hides from windows and
  buries her head to avoid seeing lightning.
•  
• Phobias an anxiety disorder marked by a
  persistent, irrational fear and avoidance of a
  specific object or situation it is an
  irrational fear that disrupts behavior. Many
  people accept and live with this common
  psychological disorder, but some specific phobias
  can lead to incapacitating efforts to avoid the
  feared situation.
•  
• Other people suffer from irrational fears of
  specific animals, insects, heights, blood, or
  tunnels. Potentially embarrassing social
  situations are difficult for those with social
  phobia an intense fear of being scrutinized by
  others social phobia is shyness taken to an
  extreme.

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4. Obsessive-Compulsive Disorder

• Obsessive-compulsive disorder an anxiety
  disorder characterized by unwanted repetitive
  thoughts (obsessions) and/or actions
  (compulsions).
• As with most other disorders, we all experience
  aspects of this phenomenon but obsessive
  thoughts and compulsive behaviors cross the fine
  line between normality and disorder when they
  become so persistent that they interfere with
  everyday living and cause a person distress.
  Checking doors and washing hands are normal
•  
• For suffers of OCD, the obsessive thoughts
  become so haunting, the compulsive rituals so
  senselessly time-consuming, that effective
  functioning becomes impossible.
•  
• Billionaire aviator Howard Hughes and germs

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• Obsession A young woman is continuously
  terrified that cars might careen onto the
  sidewalk and run her over.
•  
• Compulsion The woman walks as far from the
  street as possible and wears red clothes to be
  visible to drivers.
•  
• Obsession A mother is tormented by the concern
  that she might inadvertently contaminate the food
  she cooks for her family.
•  
• Compulsion Every day she sterilizes all cooking
  utensils and scours every pot and pan before
  cooking she also wears rubber gloves while
  handling food.
•  
• Obsession A man cannot rid himself of the
  thought that he might accidentally leave his gas
  stove on, causing his house to explode.
•  
• Compulsion Every day he feels the irresistible
  urge to check the stove exactly 10 times before
  leaving for work.
•  
• Researchers estimate that approximately 4
  million Americans have OCD at some time in their
  life this makes OCD more common than panic
  disorder or even schizophrenia it generally
  appears before the age of 25.

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Post-Traumatic Stress Disorder (PTSD)

• Traumatic stress experiencing or witnessing
  severely threatening, uncontrollable events with
  a sense of dear, helplessness, or horror can
  produce post-traumatic stress disorder an
  anxiety disorder characterized by haunting
  memories, nightmares, social withdrawal, jumpy
  anxiety, and/or insomnia that lingers for 4 weeks
  or more after a traumatic experience.
•  
• Combat veterans, accident/disaster survivors,
  sexual assault victims, children of war zone,
  9/11
•  
• In the recent Iraq war, one in six U.S. combat
  infantry has reported symptoms of PTSD,
  depression, or severe anxiety in the months after
  returning home.

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• Some psychologists believe the PTSD is
  overdiagnosed, due partly to a broadening
  definition of the word trauma. Debriefing
  immediately after a traumatic event has proven
  generally ineffective and sometimes harmful.
•  
• Researchers also point to the impressive
  survivor resiliency most people display about
  half of adults experience at least one traumatic
  event in their lifetime, but only 1 in 10 women
  and 1 in 20 men develop PTSD the vast majority
  of adults do not experience PTSD after a
  traumatic event.
•  
• Tedeschi and Calhoun (2004) have developed the
  idea of post-traumatic growth this idea
  states that people actually become more
  psychologically strong/sound after experiencing a
  traumatic event they often reset their
  priorities, and report higher appreciation for
  life and relationships.
•  
• What doesnt kill you makes you stronger could
  be changed to What doesnt kill you may reveal
  to you just how strong you really are.

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Explaining Anxiety Disorders 

• Anxiety is both a feeling and a thought the
  question is, where does anxiety originate? Most
  of todays psychologists have turned to 2
  perspectives
•  
• 1. The Learning Perspective
• 2. The Biological Perspective

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1. The Learning Perspective

• We know that traumatic experience often leads to
  future anxiety. Classical conditioning might
  explain why anxious people are hyper-attentive to
  possible threats and how panic-prone people come
  to associate anxiety with certain cues.
• If dogs can learn fear from a neutral stimulus,
  then humans can as well an infant learning to
  walk learns to fear falling/near-falling, which
  leads to an overall fear of heights.

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• Two specific learning processes may contribute to
  anxiety
• Stimulus generalization occurs when a person
  fears heights after a fall and later develops a
  fear of flying in an airplane without ever having
  flown (Little Albert).
• Once phobias and compulsions arise,
  reinforcement may help maintain them. Avoiding
  or escaping that fearful situation reduces
  anxiety, thus reinforcing the phobic behavior
  (washing hands reduces anxiety next time you
  feel anxious you wash your hands ? compulsion).
• Observational learning can also have an impact
  we learn by observing what others fear monkeys
  and snakes.

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2. The Biological Perspective

• The biological perspective helps explain why we
  learn some fears more readily and why some
  individuals are more vulnerable.
•  
• Evolutionary psychologists believe that natural
  selection created fears that helped our ancestors
  survive (heights, animals, storms, etc.).
• It also explains compulsory acts as exaggerated
  behaviors that once contributed to survival
  (washing, checking locked doors, grooming, etc.).

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• There also seems to be a genetic factor of
  fear/anxiety identical twins often develop
  similar phobias.
• Brain scans of OCD patients reveal elevated
  activity in specific brain areas associated with
  behaviors such as compulsive hand washing,
  checking, ordering, and hoarding.
• When the disordered brain detects something
  amiss, it seems to generate a mental hiccup of
  repeating thoughts or actions.

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Dissociation and Multiple Personalities (pg
656-657)

• Dissociative disorders disorders in which
  conscious awareness becomes separated
  (dissociated) from previous memories, thoughts,
  and feelings. Facing trauma, such detachment may
  actually protect a person from being overwhelmed
  by emotion.
•  
• The king of dissociative disorders is
  dissociative identity disorder (DID) a person
  exhibits two or more distinct alternating
  personalities also called multiple personality
  disorder.
• Not Jekyl and Hyde
• Hillside Strangler (10 murders, guilty)
•  While some believe in DID, many people feel it
  is made up or used by individuals as an excuse
  after the fact some feel it may be an effort to
  detach after a horrific event.

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Mood Disorders 

• The emotional extremes of mood disorders come
  in two principal forms
• 1. Major Depressive Disorder in which the person
  experiences prolonged hopelessness and lethargy
  until usually rebounding to normality.
• 2. Bipolar Disorder (formerly Manic-Depressive
  Disorder) in which a person alternates between
  depression and mania, an overexcited, hyperactive
  state.

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1. Major Depressive Disorder

• We have all felt depressed at one time or another
  (discouraged, uncertain, sad, or blue).
  Sometimes it is hard to find the energy to get
  things done, concentrate, eat, or sleep normally
  we are not alone. Depression is the common
  cold of psychological disorders.
•  
• Although phobias are more common, depression is
  the number one reason people seek mental health
  services as anxiety is a response to the threat
  of future loss, depression is often a response to
  past and current loss it is a warning to stop
  and take protective measures.
•  
• Major depressive disorder occurs when signs of
  depression last two weeks or more and are not
  caused by drugs or a medical condition.
•  
• Gasping vs. Chronic Shortness of Breath

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2. Bipolar Disorder

• With or without therapy, people temporarily or
  permanently return to their previous behavior
  patterns however, some people rebound to the
  opposite emotional extreme the euphoric,
  hyperactive, wildly optimistic state of mania.
  
• If depression is living in slow motion, mania is
  fast forward. Alternation between depression and
  mania signals bipolar disorder. Manic
  individuals are typically overactive, elated,
  loud, fidgety, and optimistic to the point of
  making reckless and sometimes dangerous
  decisions.
• As true with everything else, what goes up must
  come down before long, the elated mood either
  returns to normal or plunges into a depression.

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Explaining Mood Disorders

• Psychologists have tried to explain depression
  for hundreds of years any theory of mood
  disorder tries to explain the following
•  
• Many behavioral and cognitive changes accompany
  depression (when depressed, we doubt everything
  when depression lifts, these thoughts disappear).
•  
• Depression is widespread (therefore, its causes
  must be widespread as well).
•  
• Compared to men, women are nearly twice as
  vulnerable to major depression (in general, women
  are more susceptible to disorder involving
  internalized states men tend to be more
  external). 

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• Most major depressive episodes self-terminate
  (therapy usually speeds the process, but is not
  always necessary).
•  
• Stressful events related to work, marriage, and
  close relationships often precede depression (if
  anxiety is a burning fire, depression is a wet
  blanket thrown on top of it).
•  
• With each new generation, the rate of depression
  is increasing, and the disorder is striking
  earlier (in North America, todays young adults
  are three times as likely as their grandparents
  to report having suffered depression).
•  
• Todays biopsychosocial perspective is broadening
  our understanding with biological and cognitive
  explanations.

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The Biological Perspective

• Depression is a whole body disorder it involves
  genetic predispositions, biochemical imbalances,
  negative thoughts, and melancholy mood.
• Genetics Mood disorders run in families the
  risk of major depression and bipolar disorder
  increases if you have a depressed parent or
  sibling.
• Recently, scientists have focused on isolating
  specific chromosomes that may cause depression.
  Many genes have small effects that can combine
  with one another with nongenetic factors to put
  some people at greater risk for mood disorders.

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• The Brain The neurotransmitter, norepinephrine
  (arousal), is scarce during depression and
  overabundant during mania.
• A second neurotransmitter, serotonin, is also
  scarce during depression.
• Drugs that relieve depression tend to increase
  the level of these two neurotransmitters by
  blocking their reuptake or their chemical
  breakdown.
• Diet and exercise can also affect these
  neuro-transmitter levels.

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The Social-Cognitive Perspective

• Some people slide into depression for no obvious
  reason, even when life has been going well
  depressed people see the world through dark
  glasses their intensely negative assumptions
  about themselves, their situation, and their
  future lead them to magnify bad experiences and
  minimize good ones.
• Self-defeating beliefs and negative
  explanatory styles feed depression.
• Self-defeating beliefs may arise from learned
  helplessness humans act depressed, passive, and
  withdrawn after experiencing uncontrollable
  painful events.

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• Explanatory styles involves blame depressed
  people tend to explain events in terms that are
• Stable (it will last forever)
• Global (its going to affect everything I do)
• Internal (its all my fault).
• The result of these pessimistic,
  over-generalized, self-blaming attributions is a
  depressing sense of hopelessness.
• Pessimism fuels depression individualism vs.
  collectivism.

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Depressions Vicious Cycle

• Depression can be brought on by anything that
  disrupts your sense who you are and why you are a
  worthy human being. Depression-prone individuals
  respond to bad events in an especially
  self-focused, self-blaming way their
  self-esteem fluctuates more rapidly up with
  boosts and down with threats.
•  
• When down, brooding amplifies negative feelings,
  which in turn triggers depressions other
  cognitive and behavioral symptoms when things
  arent going our way, it may seem a though they
  never will.
•  
• Our depressed attitudes often elicit negative
  responses from those around us depressed people
  are at high risk for divorce, job loss, and other
  stressful life events. These losses and stresses
  only serve to compound the original depression.
  Misery may love company, but company does not
  love misery.

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• The pieces of the depression puzzle seem to be
• 1 Negative, stressful events
• 2 a pessimistic explanatory style
• 3 a hopeless, depressed state that
• 4 hampers the way the person thinks and acts
• (Which leads back to 1).
• To get out of depression, it often helps to move
  to a different environment, reverse our
  self-blame and negative attributions, turn our
  attention outward, or engage in more pleasant
  activities and more competent behavior.

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Schizophrenia

• If depression is the common cold of psychological
  disorders, chronic schizophrenia is the cancer
  nearly 1 in 100 people will develop schizophrenia
  it knows no national boundaries and affects
  both males and females (men tend to be struck
  earlier, more severely, and slightly more often).
• Literally translated, schizophrenia means
  split mind it refers not to a
  multiple-personalities split but rather to a
  split from reality that shows itself in
  disorganized thinking, disturbed perceptions, and
  inappropriate emotions and actions.

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Symptoms of Schizophrenia

• 1. Disorganized Thinking A schizophrenics
  thinking is fragmented, bizarre, and distorted by
  false beliefs delusions false beliefs, often
  of persecution or grandeur that may accompany
  psychotic disorders.
• Many psychologists believe disorganized thoughts
  result from a breakdown of selective attention.
• The normal person has the capacity to give
  undivided attention to one voice, noise, or
  action those with schizophrenia cannot do this
  even minute stimuli like cracks in the
  sidewalk, colors on walls, or the sound of wind
  can distract their entire attention.

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• 2. Disturbed Perceptions A person with
  schizophrenia may perceive things that arent
  there such hallucinations sensory
  experiences without sensory stimulation, are
  usually auditory and often take the form of
  voices making insulting statements or giving
  orders (Youre bad, Burn yourself, etc.)
•  
• When the unreal becomes real, the resulting
  perceptions are at best bizarre, at worst
  terrifying.
•  
• 3. Inappropriate Emotions/Actions The emotions
  of schizophrenia are often utterly inappropriate
  (laughing when others cry, screaming when in a
  quiet room, etc.). Other victims lapse into
  flat affect a zombielike state of apparent
  apathy.
•  
• Motor behavior may also be inappropriate the
  person may perform senseless, compulsive acts,
  such as continuously rocking or rubbing an arm.
  This who exhibit catatonia may remain
  motionless for hours on end and then become
  agitated.

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• As you can imagine, such disorganized thinking,
  disturbed perceptions, and inappropriate emotions
  and actions profoundly disrupt social
  relationships and make it difficult to hold a
  job.
• Many schizophrenics live in a private inner
  world, preoccupied with illogical ideas and
  unreal images.
•  
• Given a supportive environment, some eventually
  recover to enjoy a normal life or experience
  bouts of schizophrenia only intermittently.
  Others remain socially withdrawn and isolated
  throughout much of their lives.

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Subtypes of Schizophrenia

• Schizophrenia is a cluster of disorders the
  subtypes have some common features, but they also
  have some distinguishing symptoms.
•  
• Patients with positive symptoms may experience
  hallucinations, talk in deluded ways, and exhibit
  inappropriate actions.
•  
• Patients with negative symptoms have toneless
  voices, expressionless faces, or mute and rigid
  bodies.
•  
• Positive symptoms are the presence of
  inappropriate behaviors and negative symptoms are
  the absence of appropriate behaviors.

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• Sometimes schizophrenia develops gradually
  (chronic / process schizophrenia).
• Sometimes schizophrenia develops rapidly (acute
  / reactive schizophrenia).
• Those who develop acute/rapid schizophrenia are
  much more likely to recover as are those with
  positive symptoms of the disorder.
•  
• See Table 16.3 on pg. 671.

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Understanding Schizophrenia

• Schizophrenia is not only the most dreaded
  psychological disorder but also one of the most
  heavily researched. Most of the new research
  studies link it with brain abnormalities and
  genetic predispositions. Schizophrenia is a
  disease of the brain exhibit in symptoms of the
  mind.
• Brain Abnormalities By examining schizophrenia
  patients brains after death, researchers found
  an excess of receptors for dopamine they
  believe this results in intensified brain signals
  that create positive symptoms such as
  hallucinations and paranoia drugs that block
  dopamine often help these symptoms.

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• Researchers have also found patterns of abnormal
  brain activity in schizophrenia patients low
  brain activity in the frontal lobes (reasoning,
  planning, problem solving), highly active
  thalamus (filtering station for incoming
  stimuli), and increased activity in the amygdala
  (fear-processing center).
• If anything, this research shows that there is
  not one isolated brain abnormality that causes
  schizophrenia, but the work of several different
  problems in combination.
• There has also been significant research
  concerning maternal virus during pregnancy (see
  pg. 673-674).

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• Genetic Factors Schizophrenia is inheritable (1
  in 10 who have a parent or sibling / 1 in 2 if
  identical twins). Children adopted by someone
  who develops schizophrenia seldom catch the
  disorder.
• Researchers are now searching for specific genes
  that, in some combination, might predispose
  schizophrenia-inducing brain abnormalities.
• Psychological Factors no environmental causes
  have been discovered that will invariably, or
  even with moderate probability, produce
  schizophrenia in persons who are not related to a
  person with schizophrenia.

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• Still hoping to identify environmental triggers,
  researchers have begun following at-risk
  children and have pinpointed the following
  warning signs of schizophrenia
•  
• A mother with severe, chronic schizophrenia
• Birth complications involving oxygen
  deprivations and low birth weight
• Separation from parents
• Short attention span and poor muscle
  coordination
• Disruptive or withdrawn behavior
• Emotional unpredictability
• Poor peer relations and solo play
• As with other psychological disorder we have
  discussed, we have all experienced schizophrenic
  like behavior/emotions (lack of attention,
  suspicion of others, inappropriate behavior), but
  these things are not the norm, nor are they
  chronic. For schizophrenics, these traits are
  constant and affect their normal functioning
  lives.

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Personality Disorders

• Personality disorders psychological disorders
  characterized by inflexible and enduring behavior
  patterns that impair social functioning they do
  not include anxiety, depression, or delusions,
  they simply affect our interaction with society.
•  
• Examples
•  
• Avoidant PD fear of rejection
• Schizoid PD eccentric behaviors
• Histrionic PD shallow, attention-getting
  emotions to gain others praise/reassurance
• Narcissistic PD exaggerated feeling of
  self-importance, aided by success fantasies
• Borderline PD unstable identity,
  relationships, and/or impulsive emotions

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Antisocial Personality Disorder

• The most troubling and heavily researched
  personality disorder is antisocial personality
  disorder an individual exhibits a lack of
  conscience for wrongdoing, even toward friends
  and family members (aggressive, ruthless, con
  artists, etc.).
• Henry Lee Lucas (360 victims)
• Once Ive done a crime, I just forget it.

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Understanding Antisocial Personality Disorder 

• As with other disorders, antisocial personality
  disorder is both biological and psychological
  these individuals show little to no autonomic
  nervous arousal when impending pain/danger is
  present. This lack of danger/social
  responsibility can produce a cool con artist or a
  ruthless killer.
•  
• These people have been found to have less brain
  activity (and sometimes size) in their frontal
  lobes which control planning, organization, and
  inhibition.
•  
• Environmental factors like childhood poverty also
  seem to be a precursor to this disorder.

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Rates of Psychological Disorders

• See Tables 16.4 and 16.5 on pg. 680-681
•  
• Psychological disorders are present throughout
  the world North America, and especially the
  United States, has some of the worlds highest
  rates.
• Why do you think this is the case?

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• Those who experience a psychological disorder
  usually do so by early adulthood symptoms of
  antisocial disorder and phobias are among the
  earliest to appear at a median age of 8 and 10
  respectively. Major depression hits later with a
  median age of 25.
• These findings make it clear that research and
  treatment need to focus on younger individuals if
  preventative measures are to be taken. While
  psychological disorders can steal ones life, the
  right therapy can often bring it back.

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• 1. Research suggests that the stigma and stress
  associated with being gay increase the risk of
  mental health problems.
• --True
• 2. In some cultures, depression and schizophrenia
  are non-existent.
• --True
• 3. Research indicates that in the United States
  there are more prison inmates with severe mental
  disorders than there are psychiatric inpatients
  in all the countrys hospitals.
• --True
• 4. About 30 of psychologically disordered people
  are dangerous that is, they are more likely than
  other people to commit a crime.
• --False
• 5. Identical twins who have been raised
  separately sometimes develop the same phobias.
• --True
• 6. Dissociative identity disorder is a type of
  schizophrenia.
• --False
• 7. In North America, todays young adults are
  three times as likely as their grandparents to
  report having experienced depression.
• --True
• 8. White Americans commit suicide nearly twice as
  often as black Americans do.
• --True
• 9. There is strong evidence for a genetic
  predisposition to schizophrenia.
• --True
• 10. An estimated one in seven Americans suffers a
  clinically significant mental disorder.

53
Penn State Worry Questionnaire

• 1. If I do not have enough time to do everything,
  I do not worry about it.
• 2. My worries overwhelm me.
• 3. I do not tend to worry about things.
• 4. Many situations make me worry.
• 5. I know I should not worry about things, but I
  just cant help it.
• 6. When I am under pressure I worry a lot.
• 7. I am always worrying about something.
• 8. I find it easy to dismiss worrisome thoughts.
• 9. As soon as I finish one task, I start to worry
  about everything else I have to do.
• 10. I never worry about anything.
• 11. When there is nothing more I can do about a
  concern, I do not worry about it anymore.
• 12. I have been a worrier all my life.
• 13. I notice that I have been worrying about
  things.
• 14. Once I start worrying, I cannot stop.
• 15. I worry all the time.
• 16. I worry about projects until they are done.

Use a scale of 1-5 1 Not Typical 5 Very
Typical
54

• A. Reverse your responses to 1, 3, 8, 10, and 11
• B. Add your numbers to all 16 items.
• Scores range from 16-80 with higher scores
  reflecting a greater tendency to worry.
• Mean score 48.8 (females 51.2 / males 46.1)
•  
• Generalized anxiety disorders are characterized
  by chronic worry higher scores are linked to
  lower self-esteem, but higher levels of
  perfectionism, time urgency, and
  self-handicapping.

55
STABS

• 1. When I am in a social situation, I appear
  clumsy to other people.
• 2. If I am with a group of people, and I have an
  opinion, I am likely to chicken out and not say
  what I think.
• 3. I feel as if other people sound more
  intelligent than I do.
• 4. When I am with other people, I am not good at
  standing up for myself.
• 5. I am a coward when it comes to interacting
  with other people.
• 6. I feel unattractive when I am with other
  people.
• 7. I would never be able to make a speech in
  public.
• 8. Other people are more comfortable in social
  situations than I am.
• 9. Other people are more socially capable that I
  am.

0 Never 1 Rarely 2 Sometimes 3 Often 4
Always
56

• 10. No matter what I do, I will always be
  uncomfortable in social situations.
• 11. My mind is very likely to go blank when I am
  talking in a social situation.
• 12. I am not good at small talk.
• 13. Other people are bored when they are around
  me.
• 14. When speaking in a group, others will think
  what I am saying is stupid.
• 15. If I am around someone I am interested in, I
  am likely to get panicky or do something to
  embarrass myself.
• 16. I do not know how to behave when I am in the
  company of others.
• 17. If something went wrong in a social
  situation, I would not be able to smooth it over.
• 18. When I am with other people they usually
  dont think I am very smart.
• 19. When other people laugh it feels as if they
  are laughing at me.

57
Social Thoughts and Beliefs Scale

• Add up all of your responses.
•  
• Patients diagnosed with social phobia obtained a
  mean of 52.4.
• Those with other anxiety disorders had a mean of
  28.0.
• Controls without any psychiatric diagnosis had a
  mean score of 22.3.
•  
• 2 factors seem to be involved in social phobias
• 1. Social Comparison a belief that others are
  more socially competent and capable.
• 2. Social Ineptness a belief that one will act
  awkwardly in social situations or appear anxious
  in front of others.
•  
• Research suggest that social phobia can be
  diagnosed as early as 8 years of age it is one
  of the most common disorders in the general
  population.
•  
• These people tend to avoid potentially
  embarrassing social situations if they cannot
  avoid contact, they often experience physical
  symptoms such as trembling, profuse sweating, and
  nausea. For some, their greatest fear is that
  others will detect these bodily symptoms.

58
Obsessive-Compulsive Inventory

• 1. I have saved up so many things that they get
  in the way.
• 2. I check things more often than necessary.
• 3. I get upset if objects are not arranged
  properly.
• 4. I feel compelled to count while I am doing
  things.
• 5. I find it difficult to touch an object when I
  know it has been touched
• by strangers or certain people.
• 6. I find it difficult to control my own
  thoughts.
• 7. I collect things I dont need.
• 8. I repeatedly check doors, windows, drawers,
  etc.
• 9. I get upset if others change the way I have
  arranged things.
• 10. I feel I have to repeat certain numbers.
• 11. I sometimes have to wash or clean myself
  simply because I feel contaminated.
• 12. I am upset by unpleasant thoughts that come
  into my mind against my will.
• 13. I avoid throwing things away because I am
  afraid I might need them later.
• 14. I repeatedly check gas and water taps and
  light switches after turning them off.
• 15. I need things to be arranged in a particular
  order.
• 16. I feel there are good and bad numbers.
• 17. I wash my hands more often and longer than
  necessary.
• 18. I frequently get nasty thoughts and have
  difficulty getting rid of them.

0 Not at all 1 A little 2 Moderately 3 A
lot 4 Extremely
59

• Add up all of your answers scores range from
  0-72.
• In one study, patients with OCD obtained a mean
  score of 28.01
• In another study, psychology students at U. of
  Delaware had a mean of 18.82.
• There are 6 sub-components within the scale that
  introduce common symptoms of OCD
• A. Washing 5, 11, 17
• B. Obsessing 6, 12, 18
• C. Hoarding 1, 7, 13
• D. Ordering 3, 9, 15
• E. Checking 2. 8, 14
• F. Mental Neutralizing 4, 10, 16
• OCD traps people in seemingly endless cycles of
  repetitive thoughts (obsessions) and in feelings
  that they must repeat certain actions over and
  over (compulsions).
• Approximately 20 of those with OCD have only
  obsessions or only compulsions all other
  experience both.