I. ObedienceII. DissonanceI. DSM-IVa. Definition of mental disorderII. AutismDSM-IV Definition of Mental Disorder: “clinically significant detriment” with “distress or impaired functioning”. Endogenous- derives from internal source, not person’s immediate environment. Not subject to voluntary control.Williams-Beuren Syndrome: a rare genetic disorder (1/20,000) with physical and psychological abnormalities. Physical includes cardiovascular and renal problems, reduced brain volume, and unusual facial features. Behavioral includes mild to moderate mental retardation, but with uneven profiles- highly expressive verbally and socially; artistic interest and expression, but very impaired in spatial processing.Cause: autosomal dominant; one gene identified on chromosome 7 which codes for elastin (allows many tissues in the body to resume their shape after stretching or contracting) protein. In 95% of Williams cases, this protein is deleted.Example of OGOD principle: One Gene, One Disorder. Most mental illnesses are apparently not like thisNo way of reversing brain-based conditions such as Williams’ syndrome, but it is possible that the effects of some OGOD conditions can be reserved or prevented (such as by diet)Example: PKU: phenylketonuria, Mendelian inheritance, autosomal recessive. A defect in metabolizing phenylalanine, leading to abnormal brain development, IQs of 50. But condition can be detected at birth and effectively treated with a phenylalanine-restricted dietAutistic Spectrum Disorder: Childhood autism. Heritable neuro-developmental disability- failure to develop basic social interaction, awareness of others, communication. Late or absent social smiling. Self-involved and withdrawn- ritualistic repetitive behaviors. In about 40% of cases there is mental retardation. Large sex difference: 4x more common in males; heritable: concordance rate in MZs (90% autistic or affected)Concordance rate: if one twin has it, the probability rate that the other twin doesAutism-theories:1) Bruno Bettleheim- caused by ice-box mothers. There are no known specific psychogenic causes. Runs in families because of genetic influences, which seems to be true of many disorders.Complication: currently regarded as a spectrum disorder: can range from mild to severe, and many not have the same causes throughout the spectrumCurrent ideas:Genetic brain defects and dysfunction, aberrant pre-natal neural development- random eventsHypothesized environmental influences: mercury compounds in vaccinations; diet-related inflammation; environmental toxins. No specific causes have been reliably identifiedSimon Bar-Cohen: autism is a version of “extreme maleness”- interest in things, not people. Reports that autism may be more likely if father and mother are both “systemizers”, such as members of analytical professions“Theory of Mind” approach: autistic children may not develop the concept of others’ mindsSlide 10: Number of people known to have autism has increased since the 1980’s, partly as a result of changes in diagnostic practice- due to conceptual bracket creep. Autism’s definition has changed and broadened. Abnormality itself has not changed.Sociopathy: aka moral insanity. Psychopathic deviate, anti-social personality, sociopath. Classified as a personality disorder in the DSM-IV.Checklist for sociopathy includes: glib and superficial; egocentric and grandiose; lack of remorse or guilt, empathy; no enduring relationships- “lone wolf”; deceitful and manipulative; etc.Early warning signs: repetitive casual and seemingly thoughtless lying; apparent indifference to or inability to understand the feelings, expectations, or pain of others; etc.Example of sociopath: Jeffrey Dahmer- cannibal; main character of Bad Seed the movie; slide 16: a real bad seedHypothesis about Sociopathy from Evolutionary Psychology: sociopaths are a small minority of “cheaters” exploiting the majority who observe norms of trust, responsibility, and reciprocity. They may be people who can’t otherwise successfully compete with the majority. Sociopathy is significantly heritable- perhaps sociopaths and their genes can persist in a population as long as they aren’t too numerous.Hypothesis about proximate cause: lack of autonomic reactivity, poor conditioned emotional responses; thrill-seekers, stimulation seekers. Substance abuse is very common among sociopathsDSM IV: Diagnostic and Statistical Manual of the American Psychiatric AssociationAxis I: Clinical disorders and other conditions that may be a focus of clinical attention (schizophrenia, mood disorders, anxiety disorders, sexual and gender disorders, sleep disorders, eating disorders).Axis II: Mental retardation and personality disorders (antisocial personality disorder, paranoid personality disorder, borderline personality disorder).Axis III: General medical conditions that may be relevant to mental disorders (cancer, epilepsy, obesity, Parkinson's disease, Alzheimer's disease, vascular dementia).Axis IV: Psychosocial and environmental problems that might affect the diagnosis, treatment, and prognosis of mental disorders (unemployment, divorce, legal problems, homelessness, poverty, parental overprotection).Axis V: Global assessment of functioning (social, psychological, and occupational).Rated on a scale from 1 to 100, with l representing danger of hurting self or others and 100 meaning superior functioning in a wide range of areas.Slide 21: the Unabomber: revolted against the industrialized world. Guy was filled with rage, but where did it come from?Problems with diagnoses of mental disorders:DSM Reliability: better than it was, but it’s got a ways to go. Still problems with inter-observer reliability.DSM Validity:Sensitivity of a test: the probability that the underlying condition is actually present when the test says it is.Specificity: the probability that the underlying condition is absent when the test says it is absent.Many/most diagnostic behavioral signs have sensitivity << 1 and specificity << 1Same as saying that the correlation between diagnosis (problem present or problem absent) and actual presence of absence may not be very largeCo-morbidity: a lot of disorders that seem different tend to go together. Behavioral and mental disorders that co-vary.Some disorders may just be the extremes of natural distributions of personality traits- not disorders even if they are disruptive.Cut-off problem: behaviors vary continuously, such