Psychology Chapter 15: Psychological Disorders PDF

Chapter 15 Psychological Disorders Copyright © 2023 by Macmillan Learning. All rights reserved PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Chapter Outline (part 1) ...

Chapter 15 Psychological Disorders Copyright © 2023 by Macmillan Learning. All rights reserved PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Chapter Outline (part 1)  Defining Mental Disorders: What Is Psychopathology?  Anxiety Disorders: Excessive Fear, Anxiety, and Avoidance  Obsessive-Compulsive Disorder: Persistent Thoughts and Repetitive Behaviours  Posttraumatic Stress Disorder: Distress and Avoidance Copyright © 2023 by Macmillan Learning. All rights reserved After a Trauma  Depressive and Bipolar Disorders: Extreme Highs and Lows PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Chapter Outline (part 2)  Schizophrenia and Other Psychotic Disorders: Losing the Grasp on Reality  Disorders of Childhood and Adolescence  Personality Disorders: Extreme Traits and Characteristics Copyright © 2023 by Macmillan Learning. All rights reserved  Self-Harm Behaviours: Intentionally Injuring Oneself PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Defining Mental Disorders: What Is Psychopathology? (part 1)  Mental disorder: Persistent disturbance or dysfunction in behaviour, thoughts, or emotions that cause significant distress or impairment; no universal agreement on precise definition  Medical model: Abnormal psychological experiences are conceptualized as illnesses that, Copyright © 2023 by Macmillan Learning. All rights reserved like physical illnesses  Biological and environmental causes  Defined symptoms  Possible cures PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Defining Mental Disorders: What Is Psychopathology? (part 2)  Signs: Objectively observed indicators of a disorder  Symptoms: Subjectively reported behaviours, thoughts, and emotions  Three related general medical and classification Copyright © 2023 by Macmillan Learning. All rights reserved terms  Disorder  Disease  Diagnosis PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Theory of Physiognomy According to the theory of physiognomy, mental disorders could be diagnosed from facial features. This fanciful theory is now considered superstition but was popular from antiquity until the early 20th century. Copyright © 2023 by Macmillan Learning. All rights reserved PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Classifying Disorders: The DSM History  DSM (1952): Classification system  Describes the features used to diagnose each recognized mental disorder  Indicates how the disorder can be distinguished from other similar problems  DSM-II (1968): First revision  Provides common language for talking about disorders Copyright © 2023 by Macmillan Learning. All rights reserved  DSM-III (1980) and DSM-IV (1994)  Moved from vague disorder descriptions  Provided detailed list of symptoms/diagnostic criteria for more than 200 disorders  Improved reliability in diagnosis of mental disorders PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Current DSM  Diagnostic and Statistical Manual of Mental Disorders (DSM-5, 2013; DSM-5-TR, 2022)  Includes the fully revised text and references of the DSM-5 and updated diagnostic criteria and ICD-10-CM insurance codes.  It also features a new disorder, Prolonged Grief Disorder, and codes for suicidal behaviour and nonsuicidal self-injury. Copyright © 2023 by Macmillan Learning. All rights reserved  Most of those with a mental disorder report comorbidity.  Co-occurrence of two or more disorders in a single individual PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Disorders Appear in All Cultures  Kessler and colleagues launched the WHO World Mental Health Surveys to assess the presence of mental disorders in nearly two dozen countries worldwide.  Major mental disorders seen in North America appear similarly in countries and cultures worldwide.  Cultural context influences how mental disorders are Copyright © 2023 by Macmillan Learning. All rights reserved  Experienced  Described  Assessed  Treated PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Lifetime Prevalence of DSM-IV/CIDI Disorders Across World Health Organization (WHO) Regions Copyright © 2023 by Macmillan Learning. All rights reserved PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition A World of Difference: The Impact of Culture on Mental Disorders  DSM-5 provides framework for thinking about differences in cultural concepts of distress  Distinguishing concepts across cultures  Cultural syndromes Copyright © 2023 by Macmillan Learning. All rights reserved  Cultural idioms of distress  Cultural explanations PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Taijin Kyofusho Copyright © 2023 by Macmillan Learning. All rights reserved PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Causation of Disorders (part 1)  Medical model of mental disorder  Knowing a person’s diagnosis is useful because any given category of mental illness is likely to have a distinctive cause.  Specific etiology  Common prognosis  Biopsychosocial perspective Copyright © 2023 by Macmillan Learning. All rights reserved  Mental disorders are result of interactions among biological, psychological, and social factors.  Different individuals may experience a similar psychological disorder for other reasons. PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Proposed Models of How Disorders Develop Copyright © 2023 by Macmillan Learning. All rights reserved PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Causation of Disorders (part 2)  Diathesis–stress model  Person may be predisposed to a mental disorder that remains unexpressed until triggered by stress. Copyright © 2023 by Macmillan Learning. All rights reserved PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Oversimplifying Mental Disorders  Tendency to oversimplify mental disorders  Attributing them to single, internal causes  Highly evident in the interpretation of the role of the brain in psychological disorders  Brain scans of people with and without disorders Copyright © 2023 by Macmillan Learning. All rights reserved can give unusually strong impression that psychological problems are internal, permanent, inevitable, and even untreatable. PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition A New Approach to Understanding Mental Disorders: RDoC (part 1)  Research Domain Criteria Project (RDoC)  New initiative to guide classification and understanding of mental disorders by revealing the basic processes that give rise to them  Long-term goal  To better understand what abnormalities cause different disorders  To classify disorders based on those underlying causes rather than on observed symptoms Copyright © 2023 by Macmillan Learning. All rights reserved  Researchers study causes of abnormal functioning.  Biological factors  Psychological domains  Social processes and behaviour PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition  A New Approach to Understanding Mental Disorders: RDoC (part 2) Positive Domains/Construct : Arousal/ Negative Valence Domains/Constructs: Sensorimotor Valence Systems for Social Regulatory Systems Cognitive Systems Systems Systems Processes Systems acute threat approach attention affiliation and arousal motor actions (“fear”) motivation attachment potential threat Initial perception social communication circadian rhythms agency and (“anxiety”) responsiveness ownership to reward sustained threat sustained working memory perception and sleep and habit- responsiveness understanding of self wakefulness sensorimotor to reward loss reward learning declarative memory perception and innate motor Copyright © 2023 by Macmillan Learning. All rights reserved understanding of others patterns frustrative habit language behaviour nonreward cognitive (effortful) control of Analysis Units genes molecules cells circuits physiology behaviour PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Dangers of Labelling  Psychiatric labels can have negative consequences because of their association with negative stereotypes and stigma.  May prevent seeking help  May create a negative self-view (hopeless; worthless)  May contribute to lower self-esteem and self- Copyright © 2023 by Macmillan Learning. All rights reserved efficacy; higher levels of depressive symptoms  Applying labels to disorder and not the person with the disorder is important. PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Anxiety Disorders: Excessive Fear, Anxiety, and Avoidance  Anxiety disorder: Class of mental disorders in which anxiety is the predominant feature  People usually experience more than one type of anxiety at a time, comorbid with depression.  DSM-5-TR recognizes the following anxiety disorders Copyright © 2023 by Macmillan Learning. All rights reserved  Phobic disorders  Panic disorder  Generalized anxiety disorder (GAD) PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Anxiety Disorders: Phobic Disorders  Phobic disorders: Characterized by marked, persistent, and excessive fear and avoidance of specific objects, activities, or situations  Specific phobia  Social phobia Copyright © 2023 by Macmillan Learning. All rights reserved  Preparedness theory  Phobias can be classically conditioned. PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Preparedness Theory  Preparedness theory explains why most merry-go-rounds carry children on beautiful horses.  This mom might have Copyright © 2023 by Macmillan Learning. All rights reserved trouble getting her daughter to ride on a big spider or snake. PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Anxiety Disorders: Panic Disorder and Agoraphobia  Panic disorder: Characterized by the sudden occurrence of multiple psychological and physiological symptoms that contribute to a feeling of stark terror; panic attacks  Hereditary component; twice as prevalent among women  May include hypersensitive to physiological signs of anxiety Copyright © 2023 by Macmillan Learning. All rights reserved  Experiments with sodium lactate  Agoraphobia: Specific phobia involving fear of public places or fear something terrible will happen PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Anxiety Disorders and GAD  Generalized anxiety disorder (GAD): Chronic excessive worry accompanied by three or more of the following symptoms: restlessness, fatigue, concentration problems, irritability, muscle tension, and sleep disturbance  Biological and psychological factors contribute to GAD.  Neurotransmitter imbalance Copyright © 2023 by Macmillan Learning. All rights reserved  Occurs more often in people who are in lower SES groups, live in large cities, and have unpredictable environments; there is a higher rate in women PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Obsessive-Compulsive Disorder: Persistent Thoughts and Repetitive Behaviours  Obsessive-compulsive disorder (OCD)  Repetitive, intrusive thoughts (obsessions)  Ritualistic behaviours (compulsions) designed to fend off thoughts that interfere significantly with an individual’s functioning  Classified separately from anxiety disorders; has distinct causes and is maintained via different brain Copyright © 2023 by Macmillan Learning. All rights reserved neural circuitry  Roughly 2% of the population suffers from OCD.  Moderate to strong heritability; higher rate among women PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Posttraumatic Stress Disorder: Distress and Avoidance After a Trauma (part 1)  Posttraumatic stress disorder (PTSD) characterized by  Chronic physiological arousal  Recurrent, unwanted thoughts or images of the trauma Copyright © 2023 by Macmillan Learning. All rights reserved  Avoidance of things that call the traumatic event to mind PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Posttraumatic Stress Disorder: Distress and Avoidance After a Trauma (part 2)  Posttraumatic stress disorder (PTSD)  Approximately 1 in 6 Canadian Armed Forces members serving in Afghanistan between 2001 and 2014 received support for PTSD.  The observed rates are higher in non-Western and developing countries.  Brain imaging techniques identified important neural Copyright © 2023 by Macmillan Learning. All rights reserved correlates  Heightened amygdala activity  Decreased medial prefrontal cortex activity  Smaller hippocampus (preexisting condition) PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Hippocampal Volumes of Vietnam Veterans and Their Identical Twins Copyright © 2023 by Macmillan Learning. All rights reserved PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Depressive and Bipolar Disorders: Extreme Highs and Lows  For some people with mood disorders, moods can become so intense that they engender life- threatening actions.  Mood disorders  Mental disorders that have mood disturbances as Copyright © 2023 by Macmillan Learning. All rights reserved their predominant feature  Two main forms  Depression (unipolar depression)  Bipolar depression PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Depressive Disorders (part 1)  Major depressive disorder (or unipolar depression)  Characterized by a severely depressed mood that lasts 2 weeks or more; accompanied by  Feelings of worthlessness and lack of pleasure  Lethargy  Sleep and appetite disturbances Copyright © 2023 by Macmillan Learning. All rights reserved  Persistent depressive disorder  Same cognitive and bodily problems as in depression are present, but they are less severe and last longer, persisting for at least 2 years PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Depressive Disorders (part 2)  Double depression  Occurs when major depressive disorder and persistent depressive disorder co-occur  Moderately depressed mood that persists for at least 2 years  Punctuated by periods of major depression  Seasonal affective disorder (SAD) Copyright © 2023 by Macmillan Learning. All rights reserved  Involves recurrent depressive episodes in a seasonal pattern  Pattern due to reduced levels of light in colder seasons; higher latitudes PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Who Is at Risk?  Approximately 1 in 9 people in Canada and the United States meet the criteria for depression at some point.  Depression linked to gender, SES, hormones, and willingness to seek treatment.  Individuals with recurrent depression Copyright © 2023 by Macmillan Learning. All rights reserved  More severe symptoms, higher rates of depression in their families, more suicide attempts, and higher rates of divorce PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Neurotransmitters, Genes, and Stress  Neurotransmitters  Depression may involve absolute or relative depletion of norepinephrine and serotonin.  Some newer studies found increases.  Biochemical model of depression is incomplete.  Genes  Depression shows moderate heritability; increases as function Copyright © 2023 by Macmillan Learning. All rights reserved of severity.  Diathesis–stress model (Caspi and colleagues); influence of major stressful life events PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition The Brain and Depression Copyright © 2023 by Macmillan Learning. All rights reserved PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Negative Thoughts Contribute to Depression  Aaron Beck (1967)  Dysfunctional attitudes and negative mood states in individuals who were depressed.  Helplessness theory  Internal, stable, global causes Copyright © 2023 by Macmillan Learning. All rights reserved  Beck: Updated cognitive model of depression  Negative schema characterized by biases  Interpretation of information, attention, memory PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Bipolar Disorder  Unstable emotional condition characterized by cycles of abnormal, persistent high mood (mania) and low mood (depression); rapid cycling bipolar disorder  Lifetime risk  Common genetic risk factors Copyright © 2023 by Macmillan Learning. All rights reserved  Biological causes  Stressful life experiences  Expressed emotions PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Genetics and Life Situation Play a Role  Bipolar disorder  Has one of the highest rates of heritability; concordance from 40% to 70% for identical twins and 10% for fraternal twins  Shared genetic vulnerability for bipolar disorder and schizophrenia; likely polygenic  Evidence of pleiotropic effects  Stressful life experiences often precede manic and Copyright © 2023 by Macmillan Learning. All rights reserved depressive episodes.  People living with family members who are high in expressed emotion are more likely to relapse than are people with supportive families. PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Schizophrenia and Other Psychotic Disorders (part 1)  Schizophrenia  Disorder characterized by profound disruption of basic psychological processes  Distorted perception of reality; altered or blunted emotion; and disturbances in thought, motivation, and behaviour  Positive symptoms of schizophrenia  Hallucinations  Delusions Copyright © 2023 by Macmillan Learning. All rights reserved  Negative symptoms of schizophrenia  Disorganized symptoms  Disorganized speech  Grossly disorganized behaviour  Catatonic behaviour PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Catatonic Schizophrenia  A person who has catatonic schizophrenia may assume an unusual posture and fail to move for hours. Copyright © 2023 by Macmillan Learning. All rights reserved PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Schizophrenia and Other Psychotic Disorders (part 2)  Negative symptoms are deficits or disruptions of normal emotions and behaviours.  Emotional and social withdrawal  Apathy  Poverty of speech  Other indications of the absence or insufficiency of normal behaviour, motivation, and emotion Copyright © 2023 by Macmillan Learning. All rights reserved  Cognitive symptoms are deficits in cognitive abilities, specifically executive functioning, attention, and working memory. PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Biological Factors  Genetic factors  Concordance rates increase dramatically with biological relatedness.  Environment  Environmental factors, such as prenatal and perinatal environments, also affect concordance Copyright © 2023 by Macmillan Learning. All rights reserved rates.  Environmental stressors can trigger epigenetic changes that increase susceptibility to schizophrenia. PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Average Risk of Developing Schizophrenia Copyright © 2023 by Macmillan Learning. All rights reserved PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition The Precise Role of Neurotransmitters Is Not Fully Understood  Dopamine hypothesis  Schizophrenia involves an excess of dopamine activity.  Some believe hypothesis is incomplete.  Favourable response rate to dopamine-blocking drugs is not 100 percent. Copyright © 2023 by Macmillan Learning. All rights reserved  Difference between rapid drug blocking action and patient beneficial response.  Other neurotransmitters implicated in schizophrenia. PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Enlarged Ventricles in Schizophrenia Copyright © 2023 by Macmillan Learning. All rights reserved PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Brain Tissue Loss in Adolescent Schizophrenia Copyright © 2023 by Macmillan Learning. All rights reserved PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Social/Psychological Factors  Disturbed family environment may affect development and recovery of schizophrenia.  Disturbed families: Those with extreme conflict, lack of communication, or chaotic relationships Copyright © 2023 by Macmillan Learning. All rights reserved  Finding provides support for the diathesis- stress model. PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Other Voices: Successful and Schizophrenic  Over three decades ago, Elyn Saks received a diagnosis of schizophrenia and was informed of its grave prognosis.  She credits her success as a faculty member at USC to medication, therapy, and techniques she developed to keep her disorder at bay.  Journaling, controlling sensory input, management of symptoms at work Copyright © 2023 by Macmillan Learning. All rights reserved  An approach that looks for individual strengths and considers symptoms could help dispel mental illness’s pessimism. PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Disorders of Childhood and Adolescence  Some disorders begin in childhood or adolescence and never develop after this developmental period.  Most common are  Autism spectrum disorder (ASD)  Attention-deficit/hyperactivity disorder  Conduct disorder  Intellectual disability Copyright © 2023 by Macmillan Learning. All rights reserved  Learning disorders  Motor skill disorders  Communication disorders  Many others PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Autism Spectrum Disorder (part 1)  Autism spectrum disorder (ASD)  Condition beginning in early childhood in which a person shows persistent communication deficits as well as restricted and repetitive patterns of behaviours, interests, or activities  In DSM-5-TR, ASD subsumes multiple disorders consider separate in DSM-IV Copyright © 2023 by Macmillan Learning. All rights reserved  Autistic disorder  Asperger’s disorder  Childhood disintegrative disorder  Pervasive developmental disorder not already specified; no longer recognized in DSM PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Autism Spectrum Disorder (part 2)  Current estimates  Approximately 230 per 10,000 (1 in 44) children in the full range of disorders that now fall under the ASD umbrella in the DSM–5–TR  Theories  Early theories: Childhood schizophrenia  Current theory: Heterogeneous set of traits that cluster together in some families Copyright © 2023 by Macmillan Learning. All rights reserved  One current model  Impaired capacity for empathizing  Superior capacity for systematizing  Highly variable trajectories PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Hot Science: Optimal Outcome in Autism Spectrum Disorder  Researchers have documented many instances in which some portion of children are diagnosed with autism in childhood but who no longer meet the criteria for ASD later in life.  Explanations: Misdiagnosed; milder form of the disorder and/or were identified and treated earlier.  Dawson, Lovaas, and others  Early detection and treatment can lead to positive outcomes for Copyright © 2023 by Macmillan Learning. All rights reserved those with ASD. Should we screen all children for this disorder to maximize their chances of optimal outcomes? PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Attention-Deficit/Hyperactivity Disorder  Attention-deficit/hyperactivity disorder (ADHD)  Persistent pattern of severe problems with inattention and/or hyperactivity or impulsiveness that cause significant impairments in functioning  Criteria for a diagnosis of ADHD three different ways  Predominantly inattentive symptoms  Predominantly hyperactive/impulsive symptoms  Combined presentation (DSM–5–R) Copyright © 2023 by Macmillan Learning. All rights reserved  ADHD defined by the presence of a wide range of symptoms; it is unlikely that it emerges from one single cause or dysfunction; strong biological influence  Effective drug treatments PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Conduct Disorder  Conduct disorder  Persistent pattern of deviant behaviour involving aggression towards people or animals, destruction of property, deceitfulness or theft, or serious rule violations.  Incidence; gender differences Copyright © 2023 by Macmillan Learning. All rights reserved  Criteria for diagnosis  Range of genetic, biological, and environmental factors  Comorbidity PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Personality Disorders: Extreme Traits and Characteristics  Personality disorder  Characterized by deeply ingrained, inflexible patterns of thinking, feeling, or relating to others or controlling impulses that cause distress or impaired functioning  DSM–5–TR lists 10 specific personality disorders that fall into three clusters  Odd/eccentric  Dramatic/erratic Copyright © 2023 by Macmillan Learning. All rights reserved  Anxious/inhibited  Diagnosis controversial and complicated  Type or trait dimensions PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Antisocial Personality Disorders  Antisocial personality disorder (APD)  Pervasive pattern of disregard for and violation of the rights of others that begins in childhood or early adolescence and continues into adulthood  History of conduct disorder before age 15 Copyright © 2023 by Macmillan Learning. All rights reserved  Occurrence is 3.6% of general population (occurs in men three times more than in women)  Sociopaths, psychopaths  Brain abnormalities may be present PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Self-Harm Behaviours: Intentionally Injuring Oneself  DSM–5–TR includes two self-destructive behaviours in Section III (disorders in need of further study)  Suicidal behaviour disorder  Nonsuicidal self-injury disorder Copyright © 2023 by Macmillan Learning. All rights reserved PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Suicidal Behaviour  Suicide  Intentional self-inflicted death  Second most common cause of death for people aged 15 to 34 in Canada  Large demographic differences in rate  Nonfatal suicide attempt  Potential harmful behaviour with some intention of dying; higher Copyright © 2023 by Macmillan Learning. All rights reserved incidence than suicide deaths  Variety of motives for suicide  Escape from an intolerable state of mind or impossible situation  Greater tendency to try to escape from aversive situations PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Age of Onset of Suicidal Behaviour During Adolescence Copyright © 2023 by Macmillan Learning. All rights reserved PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition Nonsuicidal Self-Injury  Nonsuicidal self-injury (NSSI)  Direct, deliberate destruction of body tissue in the absence of any intent to die  Absent in childhood; increases in adolescence; decreases across adulthood  Characterized by strong emotional and Copyright © 2023 by Macmillan Learning. All rights reserved physiological responses to negative events  Understanding of genetic and neurobiological influences and effective medication is limited PSYCHOLOGY Schacter | Gilbert | Nock | Johnsrude Canadian Sixth Edition