- Non-psychotic disorders (aka neurotic disorders)o Obsessive-Compulsive Disorder (OCD) Repetitive, intrusive thoughts (obsessions), ritualistic behaviors (compulsions) that interfere significantly with an individual’s functioning Debilitating, actually impairs functioning E.g. obsession- “did I run someone over with my car?” repeats over in your head, compulsion- drive around the block to check if you ran someone over (multiple times) E.g. “did I turn the stove off?”, leave the house, “did I turn the stove off?”, checkto see if you turn it off (over and over) Checking behavior is reinforced ~1.3% of population Moderately heritable Problem suppressing thoughts Video:- Woman, Stephanie, with child, Jake, fears that someone might kidnap her child- Sets up traps so that if someone does kidnap her child she can tell- When she goes on walks Jake has to be in front of him the whole time- Also is afraid of “contamination”- avoids litter when out for a walk- Washes her hands every time before she interacts with Jake (22 times ina half hour!)- Lathers hand completely, scrapes under nails, washes hands again, then rinses again- She knows her anxiety is irrational but can’t stop/control it To treat: stop them from doing the ritual (e.g. have them touch something dirty and not wash their hands) Causes- Learning theory- Link to panic disorder and agoraphobia (learning component) Caudate nucleus region of brain dysfunctional Caudate nucleus is part of the basal ganglia Basal ganglia help impulse suppression (can’t turn off their thoughts) Theory is that the prefrontal cortex is overactive Strep infection may cause OCD (by affecting the caudate nucleus region)o Anxiety disorder Interpretation of normal behavior/fear that is amplified (washing hands  washing hands all the time in really hot water) Biological factors Inhibited temperaments Increased CNS activation  panic disorder E.g. a normal person would read the sentence “the doctor examined Emma’s growth” as a checkup, whereas those with anxiety disorder may interpret it as Emma having cancer People with a biological risk of having a panic disorder (with a family history of anxiety) have a higher chance of having a panic attack after hyperventilating andafter inhaling carbon dioxideo Treating anxiety disorder Specific phobias: hierarchies of fear, teaching people to relax and gradually exposing them to things they are more afraid of Cognitive-behavioral methods Virtual treatments for fears E.g. someone with social phobia: first talking to a stranger, later hosting a party, etc. E.g. phobia of germs: touch the table, touch the doorknob, touch the escalator railing, dig through the trash, etc.o Cognitive behavioral treatment Look at thinking and restructuring the thinking May change beliefs May use mindfulness meditation (awareness of the present, thoughts and feelings; identifying symptoms when they come up) or stress reduction Cognitive therapy: help people understand their thinking Cognitive restructuring: stops people from making assumptions and automatic thoughts  realistic thinking  Cognitive Behavioral Therapy (CBT): treatment using combo of thinking and behavior We may have irrational thoughts  rethinking those beliefso Cognitive behavioral are the most effective for anxiety disorders, but for others medication can be helpful SSRIs  social phobia Lower chance of relapse with mediation CBT is very effective for panic disorder, imipramine is too, a placebo helps too (b/c you don’t know that it’s a placebo), CBT & imipramine = most effectiveo OCD- exposure and response prevention Expose to something afraid of & prevent them from their normal behavior E.g. touching a doorknob and not letting them wash their hands (phobia of germs) Some reduction in OCD with medication Little with placebo Exposure & ritual prevention is most effective- Mood disorderso Overlap between depression and anxiety, some medications are helpful for botho Over 70% depressed also have generalized anxiety disorder (anxious, fatigued, muscle tension, etc.)o Significant relationship with social phobia as wello Small relationship with panic &/or agoraphobia, specific phobia, OCDo The Real World: Suicide Risk & PreventionCause of death for a lot of peopleHalf of people who commit suicide are depressedMany motives Can be biologicalOthers can influence youHard to predict, but there are warning signsYoung black males and many white males are at risk, old white males are highly at risk, females are at lower risk than maleso Major depressive episodeNot just a slump & unmotivatedSignificant difficulty simply functioningMight be trying to act like they are okay, but aren’tLess interested in activities, low pleasureThings that used to be fun aren’t funSignificant weight loss or gainSleep disturbances (insomnia and hypersomnia)Psychomotor agitation/psychomotor retardation (movement or lack of movement for no specific reason (such as pacing))Fatigue, loss of energyFeel worthless, guiltyCan’t think/concentrateThoughts of death (“relief” from life)Sometimes have no feelings at all, feel emptyOften lose social support system because no one wants to be around themo Psychotic features Hallucination (can be auditory)- E.g. hearing voices (of someone they know, or don’t) saying “you’re worthless”Delusions (e.g. someone is telling the neighbors I’m worthless over the news)May first think they have schizophrenia if hearing voices, but if the voices are saying what a depressed person would be thinking it could just be depressiono Another type of depression, less severe: dysthymia disorder (neurotic depression)Chronic (2+ years, long term)Not so debilitating that they can’t functionUnder or over eatingUnder or over sleepingLow energyFatigueLow self-esteemCan’t concentrateFeel hopelessDescribe it as depression but not one that makes them dysfunctionalo Bipolar disorderUsed to be called manic depressionManic and depressive episodes“2 poles”- extreme euphoria and extreme depressionIf you ever have a manic episode you qualify for manic depressionCyclothymia- no episodes of severe depression or severe manic episodes, but go into states of depression and almost mania)Bipolar I-