Psychological Disorders (Chapter 16)

1. Psychological Disorders (Chapter 16) Third Lecture Outline: Addiction Schizophrenia Child Disorders

2. Drug Abuse and Addiction • Substance abuse: Maladaptive pattern that impairs life or causes distress • Addiction: Abuse & physiological tolerance (and withdrawal symptoms) • Addiction varies by culture • Policies of abstinence leads to increase instead of decrease in addiction • Addiction has physiological, conditioning, and cognitive appraisal components (e.g., placebo effect)

3. Someone with schizophrenia “Sometimes the voices are friendly; however, most often they are cruel and taunting. Hearing voices for the first time was very scary to me. I call my voices "superiors"; they are of demonic nature and continuously telling me "I'm evil and worthless". They often command me to hurt myself. I do as they say because they threaten to kill me or bury me alive; their terror controls my behavior.” “I also have visual hallucinations in which I see things that apparently no one else sees. I look at people's faces and they suddenly disintegrate or are so distorted that they appear in horrifying form, wicked,and I see the evilness of the devil locked within their eyes. I may look at you and project someone's else's picture on your face; everything becomes confusing and quite frustrating.”

4. Schizophrenia • Negative symptoms: Behavior deficits • blunting of emotions • language deficits • apathy and social avoidance • Active symptoms: Behaviors present • delusions: disordered thinking • hallucination: unusual sensory experience • disorganised incoherent speech • other bizarre behavior

5. Diagnositic criteria • Adaptive functioning impaired • Two or more of the following: • delusions • hallucinations • disorganized or incoherent speech • grossly disorganized or catatonic behavior • negative symptoms of anhedonia • Six months of symptoms • Rule out other disorders and drugs

6. Types of Schizophrenia • Paranoid: Delusions are grandiose or persecutory; not disorganized or catatonic, e.g., tin foil in attic • Disorganized: Speech, behavior, and/or affect is inappropriate, not catatonic • e.g., roams the streets mumbling • Catatonic: Motor disturbance such as catalepsy (waxy flexibility) or frozen • Videotape #98: Cases

7. Biological basis of schizophrenia • Genetics: Schizophrenia “runs in families” • General population rate: 1 to 2 % • twin studies: monozygotic twins (100% genes), 44% concordant • dizygotic twins (50% genes) are 15% concordant • consaguinity studies: other relatives 5-10% • adoption studies: twins adopted away still have higher concordance than base rate

8. Brain and neurotransmitter anomolies • Dopamine hypothesis supported by drug effects • Amphetamine psychosis from too much dopamine • Parkinsonian tremors from too little: chlorapromazine side effect

9. Vulnerability-Stress Model • Late teen, young adult, age of onset 18-30 Biological Vulnerability Stressful Experiences Schizophrenia Symptoms

10. Examples of childhood disorders • Attention-deficit hyperactivity disorder • Innattention, impulsivity, hyperactivity • Conduct disorders • stealing, truancy, fighting, swearing, destructive behavior • Pervasive Developmental Disorder (Autism) • communication deficts, perserveration, echolalia, memory