Psychological Disorders

Dissociative Disorders

• Controversial, rare disorders in which conscious awareness becomes separated (dissociated) from previous memories, thoughts, and feelings.
• Dissociative Identity Disorder (DID) (formerly multiple personality disorder)
  • Rare dissociative disorder in which a person exhibits two or more distinct and alternating personalities.
• Chris Sizemore’s story, The Three Faces of Eve, gave early visibility to what is now called dissociative identity disorder.

Personality Disorders

• Inflexible and enduring behavior patterns that impair social functioning.
• Antisocial Personality Disorder
  • A person with antisocial personality disorder displays:
    • Lack of conscience for wrongdoing, even toward friends and family members.
    • Lack of empathy.
    • Often impulsiveness, fearlessness, irresponsibility.
  • Sociopaths or psychopaths.
• Most criminals do not exhibit the same lack of conscience as convicted killer Dennis Rader, also known as the “BTK killer.”

Eating Disorders

• Statistics:
  • 13 million Americans binge eat.
  • 10 million women battle anorexia or bulimia.
  • 1 million men battle anorexia or bulimia.
• Body Size Comparison:
  • Average American woman: 5'4", 140 lbs.
  • Average female fashion model: 5'11", 110 lbs.

Anorexia Nervosa

• Person (usually an adolescent female) maintains a starvation diet despite being significantly underweight.
• People with anorexia nervosa continue to diet and sometimes exercise excessively because they view themselves as fat.
• This is the deadliest of all psychological disorders.
• Incidence rate in America: 0.6%.
• Diagnostic criteria:
  • Restriction of energy intake relative to requirements, leading to significantly low body weight for the patient’s age, sex, developmental trajectory, and physical health. Significantly low weight is defined as a weight that is less than the minimal normal weight or, in children and adolescents, less than the minimal expected weight.
  • Intense fear of gaining weight or of becoming fat, or persistent behavior that interferes with weight gain, even though the patient has a significantly low weight.
  • Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or persistent lack of recognition of the seriousness of the current low body weight.

Bulimia Nervosa

• Person alternates binge eating (usually of high-calorie foods) with purging (by vomiting or laxative use), sometimes followed by fasting or excessive exercise.
• Incidence rate in America: 1%.
• Diagnostic Criteria:
  • Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
    • Eating, in a discrete period of time (e.g., within a two hour period), an amount of food that is definitely larger than what most people would eat during a similar period of time and under similar circumstances.
    • Lack of control over eating during the episode (e.g., a feeling that you cannot stop eating, or control what or how much you are eating).
  • Recurrent inappropriate compensatory behavior to prevent weight gain, such as self-induced vomiting, misuse of laxatives, diuretics, or other medications, fasting, or excessive exercise.
  • The binge eating and inappropriate compensatory behaviors both occur, on average, at least once a week for three months.
  • Self-evaluation is unduly influenced by body shape and weight.
  • Binging or purging does not occur exclusively during episodes of behavior that would be common in those with anorexia nervosa.

Binge-Eating Disorder

• Significant binge eating, followed by distress, disgust, or guilt, but without the compensatory purging or fasting that marks bulimia nervosa.
• Incidence rate in America: 2.8%.
• Diagnostic Criteria:
  • Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
    • Eating, in a discrete period of time (for example, within any two-hour period), an amount of food that is definitely larger than most people would eat in a similar period of time under similar circumstances.
    • A sense of lack of control over eating during the episode (for example, a feeling that one cannot stop eating or control what or how much one is eating).
  • The binge-eating episodes are associated with three (or more) of the following:
    • Eating much more rapidly than normal.
    • Eating until feeling uncomfortably full.
    • Eating large amounts of food when not feeling physically hungry.
    • Eating alone because of feeling embarrassed by how much one is eating.
    • Feeling disgusted with oneself, depressed, or very guilty afterwards.
  • Marked distress regarding binge eating is present.
  • The binge eating occurs, on average, at least once a week for three months.
  • The binge eating is not associated with the recurrent use of inappropriate compensatory behavior (for example, purging) and does not occur exclusively during the course of anorexia nervosa, bulimia nervosa, or avoidant/restrictive food intake disorder.
  • It is extremely important to note that weight or appearance is not part of the diagnostic criteria for binge eating disorder.

Understanding Eating Disorders

• Family environment for those diagnosed with anorexia is often competitive, high-achieving, protective
• Those with eating disorders often have low self- evaluations, set perfectionistic standards, and are intensely concerned with how others perceive them.
• Cultural pressures: Ideal body shapes vary across cultures and time.
• Other influences: Low self-esteem and negative emotions interact with stressful life experiences.

Neurodevelopmental Disorders

• Autism Spectrum Disorder (ASD)
  • Cognitive and social-emotional disorder marked by social deficiencies and repetitive behaviors.
  • Diagnoses across countries.
  • Underlying source of symptoms; impaired theory of mind.
  • Levels of severity.
  • Biological factors: Prenatal environment, genes and genetic mutations; gender differences; brain functioning.
  • Childhood vaccinations have no relationship to the disorder.
• Characteristics of ASD vary in significance from person to person:
  • Eye contact.
  • Social issues.
  • Sensitivity to external stimuli.
  • Need for routine.
  • Poor executive function (logical thinking, impulse control).
  • Communication problems.
  • Restricted interests.
  • Anxiety.
  • Stimming (self-stimulation behaviors).
  • Meltdowns.

Attention-Deficit/Hyperactivity Disorder (ADHD)

• Psychological disorder marked by extreme inattention and/or hyperactivity and impulsivity.
• Diagnosis in United States; gender differences.
• Symptoms.
• Causes: Genetic, co-existing with learning disorder or with defiant and temper-prone behavior.
• Treatment: Stimulant drugs, psychological therapies.
• Skeptics and supporters debate.
• Diagnosis in the U.S.:
  • 9.4% of 2- to 17-year-olds
  • 2.5% of adults
• Twice as often in boys as in girls.
• Less often in many other countries, such as Norway and Sweden.
• Skeptics note:
  • Energetic child + boring school = ADHD overdiagnosis
  • Children are not designed to sit for hours in chairs inside.
  • The youngest children in a class tend to be more fidgety and more often diagnosed.
  • Older students may seek out stimulant ADHD prescription drugs-