Mental and Physical Health: Clinical Psychology

Mental Health Facts in America

  • 43.8 million adults experience mental illness in a given year.

  • 1 in 5 adults in America experience a mental illness.

  • Nearly 1 in 25 (10 million) adults in America live with a serious mental illness.

  • One-half of all chronic mental illness begins by the age of 14; three-quarters by the age of 24.

Prevalence of Mental Illnesses (U.S. Adults)

  • Millions of people are affected by mental illness each year.

  • Many people work, perform, create, compete, laugh, love, and inspire every day despite their mental illness.

  • 1 in 20 U.S. adults experience serious mental illness.

  • 1% Schizophrenia

  • 1% Personality Disorder

  • 4% Dual Diagnosis

  • 3% Bipolar Disorder

  • 19% Anxiety Disorders

  • 8% Depression

  • 1% Obsessive Compulsive Disorder

  • 4% Post-traumatic Stress Disorder

  • 17% of youth (6-17 years) experience a mental health disorder

Prevalence of Any Mental Illness (U.S. Adults)

  • 21% of all adults

  • 14% of Asian adults

  • 17% of Black adults

  • 17% of Native Hawaiian or Other Pacific Islander adults

  • 18% of Latinx/Hispanic adults

  • 19% of American Indian or Alaska Native adults

  • 22% of White adults

  • 32% of adults who report mixed/multiracial

  • 44% of lesbian, gay, and bisexual adults

Explaining and Classifying Psychological Disorders

  • Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR)

Defining & Diagnosing Disorders

  • Psychopathology: the scientific study of mental disorders and different types of maladaptive behaviors

  • Psychological Disorder: clinically significant disturbance in an individual’s cognition, emotion regulation, or behavior

  • 3 Ds:

    • Deviance

      • Varies by culture, varies over time

    • Distress

      • Worrisome, problematic for self & others

    • Dysfunction

      • Key in defining disorders

      • Impairment in daily functioning

Classifying Disorders

  • Comprehensive

  • Consider symptoms, severity, duration and impact

  • Cultural background and context

  • Pros to Diagnosing:

    • validation, access to treatment, improvement

  • Cons to Diagnosing:

    • labeling, unnecessary medications, overdiagnosing

The DSM: Diagnosing Disorders

  • Classification based on symptoms

  • Diagnostic classification describes, predicts, implies treatment, and stimulates research

  • DSM-5-TR: APA Diagnostic and Statistical Manual of Mental Disorders (5th Edition-TR) (2022)

  • Evolution of the DSM: DSM-I (1952), DSM-II (1968), DSM-III (1980), DSM-III-R (1987), DSM-IV (1994), DSM-IV-TR (2000), DSM-5 (2013), DSM-5-TR (2022)

Perspectives on Disorders

  • Behavioral

  • Psychodynamic

  • Humanistic

  • Cognitive

  • Evolutionary

  • Sociocultural

  • Biological

  • Eclectic Approach

Perspectives on Disorders: Details

  • Behavioral

    • Associative learning (Classical & Operant)

      • PTSD, Panic, Phobia, Illness Anxiety Disorder

  • Psychodynamic

    • Childhood experiences and past traumas

      • Personality disorders, DID

  • Humanistic

    • Low self-esteem, low self-concept

      • Self-actualizing goals

    • General mental health, not disorder specific

  • Cognitive

    • Illogical, irrational, maladaptive thoughts

      • Depression, Anxiety, OCD, Eating Disorders, Personality Disorders

  • Evolutionary

    • Inherited reactions to environment, beneficial in past

      • Anxiety disorders: response to threats

      • Depression: response to loss, time to reflect

Perspectives on Disorders

  • Sociocultural

    • Societal, group, and cultural influences

    • Cultural relativism: understanding behavior in the context of one’s culture

      • Gender, socioeconomic status, age, values, traditions, etc.

  • Biological

    • Medical Approach: genetics, brain, neurotransmitters/hormones

    • Medication Therapies, Biomedical interventions

      • Schizophrenia, Bipolar Disorder, Depression

Risk and Protective Factors for Mental Disorders

  • Risk Factors:

    • Academic failure

    • Birth complications

    • Caring for chronically ill or patients with neurocognitive disorder

    • Child abuse and neglect

    • Chronic insomnia

    • Chronic pain

    • Family disorganization or conflict

    • Low birth weight

    • Low socioeconomic status

    • Medical illness

    • Neurochemical imbalance

    • Parental mental illness

    • Parental substance abuse

    • Personal loss and bereavement

    • Poor work skills and habits

    • Reading disabilities

    • Sensory disabilities

    • Social incompetence

    • Stressful life events

    • Substance abuse

    • Trauma experiences

  • Protective Factors:

    • Aerobic exercise

    • Community offering empowerment, opportunity, and security

    • Economic independence

    • Effective parenting

    • Feelings of mastery and control

    • Feelings of security

    • Literacy

    • Positive attachment and early bonding

    • Positive parent-child relationships

    • Problem-solving skills

    • Resilient coping with stress and adversity

    • Self-esteem

    • Social and work skills

    • Social support from family and friends

Biopsychosocial Approach

  • Biological influences:

    • evolution

    • individual genes

    • brain structure and chemistry

  • Psychological influences:

    • stress

    • trauma

    • learned helplessness

    • mood-related perceptions and memories

  • Social-cultural influences:

    • roles

    • expectations

    • definitions of normality and disorder

Diathesis-Stress Model

  • Diathesis (vulnerability)

    • Genetic factors

    • Biological factors

    • Personality traits

  • Stressors

    • Traumatic life events

    • Negative family life

    • Socioeconomic factors

  • The model explains how predisposition and stress interact to produce psychological disorders.

  • Low Predisposition-Low Stress

  • High Predisposition-Low Stress

  • Low Predisposition-High Stress

  • High Predisposition-High Stress

  • Puzzle analogy: Illustrates the likelihood of normal or abnormal outcomes based on predisposition and stress levels.

The Rosenhan Experiment

  • Raises questions about the validity of psychiatric diagnoses and the experiences of individuals in mental institutions.

Selection of Categories of Psychological Disorders

  • Different categories of psychological disorders will be discussed.

Neurodevelopmental Disorders

  • Affect central nervous system functioning.

  • Developmental period: prenatal -> adolescence

  • Usually include deficits that impact social functioning, academics, and/or personal functioning

  • Behaviors compared to averages for age

  • Examples: ADHD & Autism Spectrum Disorder (ASD)

ADHD (Attention-Deficit Hyperactivity Disorder)

  • Appearance by age 7 of one or more of three key symptoms:

    • Inattention

    • Hyperactivity

    • Impulsivity

  • Effects:

    • 2-3x more in boys than girls

    • Diagnoses quadrupled from 1987-1997

    • Teens and Adults

Autism Spectrum Disorder (ASD)

  • Communication disorder

  • Social Challenges

    • Social and emotional interaction

    • Nonverbal communication

    • Social relationships

  • Prevalence

    • 1 in 31 (or 3.2%) 8-year-old children were diagnosed with autism in 2022, up from 1 in 36 (2.7%) in 2020.

    • Among 4-year-old children, autism prevalence was 1 in 34 (or 2.9%), with sharp increases in diagnosis rates around 36 months—possibly reflecting increased use of telehealth during the pandemic.

    • Boys were 3.4 times more likely than girls to be diagnosed with autism.

    • Prevalence was lowest among white children (2.7%) and highest among American Indian or Alaska Native children (3.8%), Asian or Pacific Islander children (3.8%) and Black children (3.7%). Hispanic (3.3%) and multiracial (3.2%) children also had higher rates of diagnosis than white children. This continues a trend first seen in 2020 and points to progress in autism identification in historically underserved communities.

    • In 5 surveillance sites, autism prevalence was higher in areas with lower median household income or greater social vulnerability.

  • Co-occurring conditions:

    • Over a third (39.6%) of children with autism also had co-occurring intellectual disability. This number was even higher among Black children (52.8%) and American Indian or Alaska Native children (50%), possibly due to factors like lower income, food and housing insecurity, or limited access to early intervention.

Autism Spectrum Disorder (DSM 5 Criteria)

  • A. Social Interactions (must meet all 3)

    • Nonverbal Communication

    • Social/Emotional Reciprocity

    • Difficulty with relationships

  • B. Restrictive/Repetitive Stereotyped behavior- 2 or more

    • Stereotyped or repetitive motor movements, use of objects, or speech

    • Insistence on sameness, inflexible adherence to routines, or ritualized patterns or verbal nonverbal behavior

    • Highly restricted, fixated interests that are abnormal in intensity or focus (e.g, strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interest).

    • Hyper- or hypo reactivity to sensory input

  • Onset of symptoms in early developmental period (usually prior to age 3)

Possible Causes of Neurodevelopmental Disorders

  • Genetics, neurological, and environmental factors

  • ADHD:

    • Runs in families

    • Dopamine & norepinephrine issues

  • ASD:

    • Genetics (prenatal indicators)

    • Concerns about environmental toxins

    • Older parental age

    • Not related to vaccination

Schizophrenic Spectrum Disorders

  • Psychotic Disorders: delusional disorder, brief psychotic disorder, schizophreniform disorder

  • 1 in 100 people suffer from Schizophrenia

  • Emerges: Adolescence into young adulthood

  • No cultural influences

  • Equal for males and females

  • Men develop earlier, more severely, more often

  • Schizophrenia: disorganized and delusional thinking, disturbed perceptions, and inappropriate actions and emotions. (must have 2)

    • Translates to “Split Mind”—Split from reality

Symptoms of Schizophrenia

  • Disorganized Thinking

    • Delusions: false beliefs

      • Often of grandeur or persecution (paranoid tendencies are more common)

    • Disorganized Speech: switching topics, rhyming, “word salad”

  • Disturbed Perceptions

    • Hallucinations: false sensory experiences (*auditory [voices], visual)

  • Inappropriate Emotions and Actions

    • Angry for no reason; laughing at sad events

    • Flat affect: “zombie”

    • Senseless and compulsive behaviors

    • Catatonia: motionless for hours

Types of Symptoms

  • Positive Symptoms

    • Definition: Addition of inappropriate behavior, not present in healthy individuals

    • Examples: Hallucinations, delusions, vocalization

  • Negative Symptoms

    • Definition: Absence of typical behavior

    • Examples: Catatonia, mutism, flat affect

  • Acute v. Chronic

    • Acute (Reactive): onset is more sudden; reaction to stress; better recovery

    • Chronic (Process): develops gradually, worse prognosis

Brain Abnormalities

  • Dopamine overactivity– high levels may increase positive symptoms

    • Drugs to decrease dopamine

  • Abnormal Brain Activity and Anatomy

    • Frontal lobes (reasoning and problem solving)

    • Decline in brain waves

    • Fluid-filled areas and shrinking cerebral tissue

    • Possibly due to problems in prenatal development and/or delivery

Other Factors

  • Maternal Virus During Mid Pregnancy

    • Flu

    • Densely populated areas w/ many viruses

  • Genetic Factors

    • Inherit a predisposition to certain brain abnormalities

    • Original Odds: 1 in 100….change to 1 in 10 with sibling or parent with disorder and 1 in 2 with identical twins

Research suggests that schizophrenia may have several possible causes:

  • Genetics. Schizophrenia isn’t caused by just one genetic variation, but a complex interplay of genetics and environmental influences. Heredity does play a strong role—your likelihood of developing schizophrenia is more than six times higher if you have a close relative, such as a parent or sibling, with the disorder

  • Environment. Exposure to viruses or malnutrition before birth, particularly in the first and second trimesters has been shown to increase the risk of schizophrenia. Recent research also suggests a relationship between autoimmune disorders and the development of psychosis.

  • Brain chemistry. Problems with certain brain chemicals, including neurotransmitters called dopamine and glutamate, may contribute to schizophrenia. Neurotransmitters allow brain cells to communicate with each other. Networks of neurons are likely involved as well.

  • Substance use. Some studies have suggested that taking mind-altering drugs during teen years and young adulthood can increase the risk of schizophrenia. A growing body of evidence indicates that smoking marijuana increases the risk of psychotic incidents and the risk of ongoing psychotic experiences. The younger and more frequent the use, the greater the risk.

Depression Statistics

  • 300 million people worldwide experience depression (WHO, 2017)

  • 3.1 million people between ages 12 and 17 in the U.S. have experienced at least one major depressive episode in the past year

  • Median age of onset: 32.5 years old

  • Suicide is the second leading cause of death among people ages 10-34

  • 8.7% of women have depression

  • 5.3% of men have depression

  • Resources: National Alliance on Mental Illness (NAMI), Substance Abuse and Mental Health Services Administration (SAMHSA)

  • Nearly 50% of those diagnosed with depression also have an anxiety disorder

  • Depression is very treatable but 35% of adults receive none

Teen Depression

  • Sadness most of the time for a few weeks or longer.

  • Inability to concentrate or do the things you used to enjoy

  • Symptoms:

    • Feeling sad, anxious, worthless, or even "empty"

    • Loss of interest in activities you used to enjoy

    • Easily frustrated, irritable, or angry

    • Withdrawing from friends and family

    • Dropping grades

    • Changed eating or sleeping habits

    • Fatigue or memory loss

    • Thoughts about suicide or harming yourself

  • How to get help:

    • Talk to a trusted adult

    • Ask your doctor about options for professional help (psychotherapy, medication, or a combination)

    • Spend time with friends or family

    • Stay active and exercise

    • Keep a regular sleep schedule

    • Eat healthy foods

Mood Disorders

  • Mood: relatively lasting emotional or affective state

  • Mood Disorders: emotional extremes

Depressive Disorders

  • Major Depressive Disorder

  • Persistent Depressive Disorder: mild depression

Bipolar and Related Disorders

  • Bipolar I Disorder (more severe)

  • Bipolar II Disorder (less severe--includes hypomanic episodes)

  • Cyclothymic Disorder (hypomanic & dysthymia)

Diagnostic Criteria: Major Depressive Disorder

A. Five (or more) of the following symptoms have been present during the same 2-week
period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.

  1. Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad, empty, hopeless) or observation made by others (e.g., appears tearful). (Note: In children and adolescents, can be irritable mood.)

  2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation).

  3. Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day. (Note: In children, consider failure to make expected weight gain.)

  4. Insomnia or hypersomnia nearly every day.

  5. Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down).

  6. Fatigue or loss of energy nearly every day.

  7. Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick).

  8. Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others).

  9. Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

  • Major depressive disorder (in children and adolescents, mood can be irritable)

    • 5 or more of 9 symptoms (including at least 1 of depressed mood and loss of interest or pleasure) in the same 2-week period; each of these symptoms represents a change from previous functioning

      • Depressed mood (subjective or observed)

      • Loss of interest or pleasure

      • Change in weight or appetite

      • Insomnia or hypersomnia

      • Psychomotor retardation or agitation (observed)

      • Loss of energy or fatigue

      • Worthlessness or guilt

      • Impaired concentration or indecisiveness

      • Thoughts of death or suicidal ideation or suicide attempt

  • Persistent depressive disorder (in children and adolescents, mood can be irritable and duration must be 1 year or longer)

    • Depressed mood for most of the day, for more days than not, for 2 years or longer

    • Presence of 2 or more of the following during the same period

      • Poor appetite or overeating

      • Insomnia or hypersomnia

      • Low energy or fatigue

      • Low self-esteem

      • Impaired concentration or indecisiveness

      • Hopelessness

    • Never without symptoms for more than 2 months

Global Susceptibility

  • Women tend to be more susceptible to major depressive disorder around the world.

Depression Rates

  • Presents lifetime and current depression rates from 2015-2023, sourced from Gallup and ABC News.

Explaining Mood Disorders: Social-Cognitive Perspective

  • Self-defeating beliefs and negative explanatory style feed cycle of depression

    • Self-defeating beliefs – learned helplessness

      • “I can never do this”

    • Negative Explanatory Style: 3 components

      • Stable (never changing)

      • Global (impacts every area of my life)

      • Internal (it’s my fault)

Explanatory Styles

  • Stable vs Temporary

  • Global vs Specific

  • Internal vs External

  • Breakup with a romantic partner example.

  • Cognitive and behavioral changes, stressful experiences, depressed mood.

Heritability Estimates

  • Estimates the heritability of various mental disorders, including bipolar disorder, schizophrenia, anorexia nervosa, major depressive disorder, and generalized anxiety disorder.

Bipolar Disorder

  • Alternating between mania and depression.

Manic Symptoms:

  • Talkative, overactive, elated, little sleep

  • Grandiose optimism and self-esteem

  • Aggressive, irritable

  • Behaviors: excessive risk taking (ex: gambling, drug use, spending)

  • Creativity

  • Concern for meds-- people may actually “like” being manic & quit meds

  • Less common than Major Depression

  • Affects men and women equally

Bipolar I Disorder (DSM-5 Diagnosis)

  • Criteria for a manic episode must be met.

    • A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased goal-directed activity or energy, lasting at least 1 week and present most of the day, nearly every day (or any duration if hospitalization is necessary).

    • During the period of mood disturbance and increased energy or activity, 3 (or more) of the following symptoms (4 if the mood is only irritable) are present to a significant degree and represent a noticeable change from usual behavior:

      • Inflated self-esteem or grandiosity

      • Decreased need for sleep (e.g., feels rested after only 3 hours of sleep)

      • More talkative than usual or pressure to keep talking

      • Flight of ideas or subjective experience that thoughts are racing

      • Distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli), as reported or observed

      • Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation (i.e., purposeless, non-goal-directed activity)

      • Excessive involvement in activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments)

    • The mood disturbance is sufficiently severe to cause marked impairment in social or occupational functioning, or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features.

    • The episode is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication, or other treatment) or to another medical condition.

Bipolar II Disorder (DSM-5 Diagnosis)

  • Criteria have been met for at least one hypomanic episode and at least one major depressive episode

  • There has never been a manic episode

  • The occurrence of the hypomanic episode(s) and major depressive episode(s) is not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specified or unspecified schizophrenia spectrum and other psychotic disorder.

  • The symptoms of depression or the unpredictability caused by frequent alternation between periods of depression and hypomania causes clinically significant distress or
    impairment in social, occupational, or other important areas of functioning.

Contributing Causes of Bipolar Disorder

  • Biological: norepinephrine & serotonin; hormonal imbalances; structural/functional brain areas (e.g. amygdala)

  • Genetic: strong heritability, genetic mutations likely

  • Social: stressful life events, trauma, unstable living environment

  • Cultural: expression of symptoms and likelihood of accessing help

  • Behavioral: sleep, substance use:

  • Cognitive: explanatory style

Depressive & Bipolar Disorders (Episode 30)

Anxiety Disorders

  • What is anxiety?

    • a feeling of worry, nervousness, or unease

    • typically about an imminent event or something with an uncertain outcome

  • Anxiety Disorder: psychological disorder characterized by distressing, persistent, anxiety or maladaptive behaviors that reduce anxiety

    • Generalized Anxiety Disorder

    • Phobia

    • Panic Disorder

    • Agoraphobia

    • Social Anxiety Disorder

Generalized Anxiety Disorder

  • Tense, apprehensive, autonomic nervous system arousal

  • Symptoms are common; persistence is key in diagnosing (6+ months)

    • Excessive worry that can’t be controlled

    • Difficulty sleeping

    • Muscle aches/tension

    • Stomach problems, headaches

  • 2/3 women

  • Hard to find one cause

  • Often linked with depression (COMORBID)

Panic Disorder

  • Unpredictable Panic Attacks-- marked by 4+ of the following symptoms

    • Palpitations, pounding heart, or accelerated heart rate

    • Sweating

    • Trembling or shaking

    • Sensations of shortness of breath or smothering

    • A feeling of choking

    • Chest pain or discomfort

    • Nausea or abdominal distress

    • Feeling dizzy, unsteady, lightheaded, or faint

    • Feelings of unreality (derealization) or being detached from oneself (depersonalization)

    • Fear of losing control or going crazy

    • Fear of dying

    • Numbness or tingling sensations (paresthesias)

    • Chills or hot flushes

  • 1 in 75 people

  • Impacts social interactions and daily life

  • Withdrawal and avoidance of social situations

Specific Phobia

  • Persistent, irrational fear and avoidance of a specific object, activity, or situation

  • Disrupts behavior and daily life

    • acrophobia (heights) or arachnophobia (spiders).

Social Anxiety & Agoraphobia

  • Social Anxiety Disorder (Formerly: Social Phobia)

    • intense fear of being judged or watched by others.

    • Social anxiety disorder is distinct from but may include agoraphobia.

    • Taijin kyofusho is a culture-bound anxiety disorder experienced mainly by Japanese people in which people fear others are judging their bodies as undesirable, offensive, or unpleasing.

  • Agoraphobia

    • intense fear of specific social situations, including using public transportation, being in open spaces, being in enclosed spaces (e.g., shops, theaters, etc.), standing in line or being in a crowd, or being outside of the home alone.

Obsessive Compulsive & Related Disorders

  • OCD

  • BODY DYSMORPHIC DISORDER

  • HOARDING

  • TRICHOTILLOMANIA (HAIR-PULLING DISORDER)

  • EXCORIATION (SKIN-PICKING) DISORDER

Obsessive-Compulsive Disorder

  • Unwanted repetitive thoughts (obsessions) and/or actions (compulsions)

  • Interfere with everyday life and cause distress

  • Late teens, early twenties

Common Symptoms/Types of OCD

  • Obsession: Contamination

    • Examples: Fear of being contaminated or contaminating others; fear of being contaminated by germs, infections, or environmental factors; fear of being contaminated by bad or immoral persons

    • Compulsion: Washing or cleaning rituals

  • Obsession: Superstition

  • Fears of certain “bad” numbers or colors

    • Compulsion: Counting

  • Compulsion: Ordering and arranging

  • Obsession: Pathologic doubt, completeness

    • Recurrent worries about doing things incorrectly or incompletely, thereby negatively affecting the patient or others

    • Compulsion: Checking excessively, performing actions in a particular order

Post-Traumatic Stress Disorder

  • Haunting memories, nightmares, social withdrawal, anxiety, and/or insomnia that lingers for 4 weeks + after a traumatic experience

  • may involve hypervigilance, severe anxiety,flashbacks to traumatic or stressful experiences, insomnia, emotional detachment, and hostility

  • Trauma: direct exposure to serious threats

  • Post-Traumatic Growth

Explaining Anxiety Disorders: Learning Perspective

  • Fear Conditioning

    • Classical conditioning—associate anxiety with certain cues

      • People, places, environments

    • Stimulus Generalization

      • Fear heights—begin to fear flying

    • Reinforcement maintains

  • Observational Learning

    • Social Learning Theory

Explaining Anxiety Disorders: Biological Perspective

  • Natural Selection

    • Fears faced by our ancestors

    • What do we learn NOT to fear?

  • Genes

    • Temperament: sensitive, high strung

    • Family esp. twins

  • Brain

    • Over arousal of brain areas for impulse control

    • Fear-learning experiences can traumatize the brain

Dissociative Disorders

  • Dissociative Disorders are characterized by dissociations from consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior.

  • Dissociative amnesia (with and without fugue)

    • Localized — Memory loss affects certain parts of an individual’s life or areas of knowledge, such as a specific duration of their youth or information about a colleague or friend.

    • Generalized — Memory loss affects significant areas of a person’s life and identity, such as the inability to recognize their job, friends, family, and more.

    • Fugue — A person adopts a new identity as they cannot recognize anyone from their past life, family, colleagues, and friends, and cannot explain who they are.

  • Dissociative identity disorder (formerly multiple personality disorder)

    • 2 or more distinct personalities

    • disruption in the individual's sense of self

Eating Disorders Statistics

  • Only 10 percent of people with eating disorders receive treatment.

  • only 35 percent seek treatment from a facility that specializes in eating disorders.

  • 91% of women surveyed on a college campus had attempted to control their weight through dieting

  • 42% of 1st-3rd grade girls want to be thinner!

    • 22% "often" or "always."

  • A young woman with anorexia is 12 times more likely to die than other women her age without anorexia.

  • 90% of those who have eating disorders are women between the ages of 12 and 25.

  • At least 1 out of every 10 people with an eating disorder is male

  • 5-10% of anorexics die within ten years of onset.

  • 18-20% die within twenty years of onset

  • 50% report ever being cured.

Eating Disorders Discussion Questions

  • What similarities and differences exist between eating disorders?

  • Why are eating disorders challenging to treat?

  • Who is most at risk of developing eating disorders?

  • What are some behavioral warning signs for eating disorders?

  • What other mental health issues may those with ED face?

  • Why is it important to understand ED?

Eating Disorders Statistics

  • AN ESTIMATED 1 IN 5 DEATHS FROM ANOREXIA ARE SUICIDES

  • 1 IN 10 PEOPLE WHO HAVE BULIMIA ALSO STRUGGLE WITH A SUBSTANCE USE DISORDER

  • ALMOST 40% OF PEOPLE WHO STRUGGLE WITH BINGE EATING DISORDER ARE MALE

Eating Disorders

Anorexia Nervosa

  • Restriction of “energy intake” leading to significantly low body weight

  • Intense fear of gaining weight

  • Disturbance in body weight, shape, and/or appearance

    • Restricting Type

    • Binge-Eating Type

  • High mortality rate

    • Cardiac issues, organ damage (kidneys, GI system)

Understanding Anorexia

  • Signs:

    • Behavioral: dieting, restricting food groups, fixation on food and exercise, avoiding events with food, cooking for others without eating,

    • Physical: brittle hair, loss of energy, skin changes, cold

  • More females (90%)| recent research shows increase in males

  • Rare before puberty

  • Cultural Influences

    • beauty

    • individuation (Westernized cultures)-- increasing across globe

  • Family influences

    • stronger likelihood if family member diagnose

Bulimia Nervosa

  • Recurrent episodes of binge eating

    • Eating an amount of food that is larger than most would eat normally

    • Sense of lack of control over eating during the episode

  • Recurrent compensatory behavior to prevent weight gain

    • Self induced vomiting, misuse of laxatives, diuretics, enimas, fasting, excessive exercise

  • Binge eating/compensatory behavior occur at least 1x week for 3 months or more

Possible Causes for Eating Disorders

  • Biological

    • Hypothalamus, cortisol, serotonin

  • Genetic

    • Family history

    • Mood disorders comorbidity

  • Social-Cultural

    • Beauty standards/thinness

    • Cultural norms around food, dieting, exercise

  • Behavioral

    • Dieting, restrictive eating, excessive exercise

  • Cognitive

    • Distorted thoughts about eating and weight/body image

Personality Disorders

  • Some maladaptive behavior patterns impair people’s social functioning without anxiety, depression, or delusions

  • Personality: Enduring pattern of thinking, feeling and acting

  • Personality Disorders: characterized by inflexible and enduring behavior patterns that impair social functioning

    • Onset in adolescence/early adulthood

    • Stability of symptoms over time

Personality Disorders: Cluster A (odd or eccentric cluster)

  • Paranoid: Suspicion and distrust, not psychotic disorder

  • Schizoid: Social detachment, restricted emotions, solitary

  • Schizotypal: Eccentric, unusual beliefs, difficulty socially; social issues

Personality Disorders: Cluster B (Dramatic, emotional, or erratic)

  • Antisocial: Disregard for the law and the rights of others, often manipulative

  • Borderline: Instability in relationships, self-image, and emotions, often intense and chaotic

  • Histrionic: Excessive emotionality, a need for attention, often engaging in dramatic behavior

  • Narcissistic: An inflated sense of self-importance, lack of empathy for others, and a strong need for admiration.

Personality Disorder: Cluster C ( anxious or fearful)

  • Avoidant: Feelings of extreme shyness, sensitivity to criticism, and avoidance of social situations due to fear of rejection.

  • Dependent: Submissive and clinging behaviors, a strong need for others to take care of them, and difficulties making decisions independently.

  • obssesive-compulsive: orderliness, perfectionism, inflexible, and unreasonable standards