Chapters 12 13 14 Flashcards
Defining Psychological disorder Culture and Time
Diagnosis of specific disorders has varied from culture to culture and overtime in the same culture
Understanding Psychological Disorders - Middle Ages
Wide variety of therapies (often cruel or barbaric) used to drive out demons or modify madness
Understanding Psychological Disorders - Philippe Pinel
Opposed brutal treatment and proposed moral treament
Viewed madness as a sickness of mind caused by severe stress and inhumane treatment
Sponsored patient dances “lunatic balls”
Understanding Psychological Disorders - The medical Model
1800s: search for physical causes of mental disorders and for curative treatment
mental illness is diagnosed on the basis of symptoms and cured through therapy, including treatment
Understanding Psychological Disorders - The biopsychosocial Model
General approach positing that biological, psychological, and social-cultural factors, all play a significant role in human functioning in the context of disease or illness
Classification in psychiatry and psychology
Provides name and description
Attempts to predict the future of a disorder
Suggests treatment
DSM - 5
American Psychiatric Association’s 2013 Diagnositc and Statistical Manual of Mental Disorders (DSM-5)
A widely used system for classifying psychological disorders
Personality disorder
o Inflexible and enduring behavior pattern that impairs social functioning
o May include withdrawal or avoidance of social contact, insecurity, instability, or manipulative behaviors
Insanity
o mental illness of such a severe nature that a person cannot distinguish fantasy from reality, cannot conduct her/his affairs due to psychosis, or is subject to uncontrollable impulsive behavior.
Hallucination
o perceiving things in the absence of stimulation
o perceiving things that are not really there.
o Can be false or distorted, but seem very real and vivid to the person experiencing it
o can involve any of the senses including vision, hearing, smell, touch, taste and movement
o different things that may cause hallucinations including substance abuse and schizophrenia.
Delusions
o False beliefs, often of persecution or grandeur, that may accompany schizophrenia and other disorders
Obsessions
o Unwanted repetitive thoughts (OCD)
Compulsions
o Unwanted repetitive actions (OCD)
Comorbidity
- the presence of one or more additional disorders (or diseases) co-occurring with a primary disease or disorder
- or the effect of such additional disorders or diseases
- The additional disorder may also be a behavioral or mental disorder.
Autism spectrum Disorder
o a serious neurodevelopmental disorder that impairs a child’s ability to communicate and interact with others
o includes restricted repetitive behaviors, interests and activities.
o These issues cause significant impairment in social, occupational and other areas of functioning.
o Autism spectrum disorder (ASD) is now defined by the American Psychiatric Association’s Diagnosis and Statistical Manual of Mental Disorders (DSM-5) as a single disorder that includes disorders that were previously considered separate — autism, Asperger’s syndrome, childhood disintegrative disorder and pervasive developmental disord
NSSI
o Nonsuicidal self-injury
o Includes cutting, burning, and hitting oneself, pulling out hair, inserting objects under the nails or skin and self-administered tattooing
o People engange in NSSI to
Gain relief from intense negative thoughts through the distraction of pain
Ask for help and gain attention
Relieve guilt by self-punishment
Get others to change their negative behavior (bullying, criticism)
Fit in with a peer group
Positive symptoms of schizophrenia
o Positive in a sense that inappropriate behaviors are present
o May laugh or cry or las out in rage at inappropriate times
Negative symptoms of schizophrenia
o Toneless voices, expressionless faces, or mute and rigid bodies
o Negative in a the sense that actions or feelings are absent when you might expect them to be present
Symptoms of Schizophrenia
o Disorganized speech
o Disturbed perceptions
o Diminished and inappropriate emotions and actions
Tardive dyskinesia
o A neurological syndrome characterized by repetitive, involuntary, purposeless movements caused by the long-term use of certain drugs called neuroleptics used for psychiatric, gastrointestinal, and neurological disorders.
Resilience
o an individual’s ability to properly adapt to stress and adversity
o Stress and adversity can come in the shape of family or relationship problems, health problems, or workplace and financial stressors, among others.
Eclectic therapeutic approach
o Selecting a mixture of what appears to be best of various doctrines, methods or styles.
o therapist chooses interventions because they work, without looking for a theoretical basis for using the technique.
o Eclectic practitioners are not bound by the theories or methodology of any one particular school
o use what they believe or feel or experience tells them will work best, either in general, or to suit the immediate needs of individual clients
Continuity Hypothesis
???
“A warm continuous relationship with the mother or permanant mother substitute is essential for healthy attachment to occur, as it gives individuals a ‘working model’ about how relationships function”
ADHD
- Attention-deficit/Hyperactivity disorder
- 11% of american 4 – 17 yrs old diagnosed
- extreme inattention, heperactivity and impulsivity
- 2.5% have ADHD sympstoms
How can symptoms of ADHD be treated?
- With medication and other theraphies
Anxiety Disorders
- Marked by distressing persistent anxiety or maladaptive behaviors that reduce anxiety
Generalized anxiety disorder
- Person Is constantly tense and uneasy for no apparent reason
Generalize anxiety disorder symptoms
- Continual worrying, often jittery, sleep deprived, concentration difficulties, often expereienced with depression
- 2/3 are women; decreases with age in many
Panic Disorder
- Person experiences sudden episodes of intense dread and often lives in fear of when the next attack might strike
Panic disorder symptoms
- Irregular heartbeat, chest pains, shortness of breath, choking, dizzeness, trembling
- Smoking increases the risk for attacks
Phobias
- Person feels irrationally and intensely afraid of a specific object or situation
Obsessive-compulsive disorder
- Person is troubled by repetitive thoughts or actions
- Occurs when obsessive thoughts and compulsive behaviors interfere with everyday life and cause distress
Post traumatic stress disorder
- Person has lingering memories, nightmares, and other symptoms for weeks after a severely threatening, uncontrollable event
PTSD usually involves
- Battle-scarred veterans and survivors of accidents, disasters, and violent and sexual assualts (2/3rd prostitutes)
- Women are at higher risks
Major depressive disorder
- Persistent state of hopeless depression
- Occurs when signs of depression last two or more weeks and are not caused by drugs or a medical condition
Bipolar disorder
- An alternation between depression and overexcited hyperactivity; less common
- May include seasonal patterns; involves a surge in diagnosis
Anorexia Nervosa
- Person (usually an adolescent female) maintains a starvation diet despite being significantly underweight
Bulimia Nervosa
- Person alternates binge eating (usually of high-calorie foods) with purging (by vomiting or laxative use), fasting or excessive exercise
Binge-eating disorder
- Significant binge eating, followed by distress, disgust, or guilt, but without the purging, fasting, or excessive exercise that marks bulimia nervosa
Dissociative disorder
- Conscious awareness becomes separated (dissociated) from previous memories, thoughts, and feelings
Dissociative identity disorder (DID)
- Rare dissociative disorder in which a person exhibits two or more distinct and alternating personalities (multiple personality disorder)
Antisocial personality disorder
- Lack of conscience for wrongdoing, even toward friend and family members
- Impulsive, fearless, irresponsible
- Some genetic tendencies, including low arousal
- Typically male; emerges before age 15; influenced by nature and nurture
DSM-5 Criticsm (Problems of diagnostic labeling of psychological disorders)
- Antisocial personality disorder and generalized anxiety disorder did poorly on field trials
- DSM-5 contributes to pathologizing of everyday life
- System labels are society’s value judgements (Rosenhan 1973)
DSM-5 Benefits
- System helps mental health professionals comnmunicate and is useful in research
Are people with psychological disorders dangerous?
- The majority of violent crimes are committed by those with no diagnosed disorders
- There is little risk of violence or harm to a stranger from casual contact with an individual who has a mental disorder
- Alcohol or drugs, previous violence, and gun available are better predictors of violence
How do anxious feelings arise - Conditioning?
Classical Conditioning helps explain?
- classical conditioning helps explain
1. How panic-prone people associate anxiety with certain cues
How do anxious feelings feelings arise - conditioning
Stimulus generalization research demonstrates
How a fearful event can later become a fear of similar events
How do anxious feelings arise - conditioning
Operant conditioning can help?
maintain a developed and generalized phobia
How do anxious feelings arise - cognition
- Observing others can contribute to the development of some fears
- Interpretations and expectations shape reactions
Schizophrenia
o Psychological disorder characterized by delusions, hallucinations, disorganized speech, and/or diminished, inappropriate emotional expression
Onset and development of schizophrenia
o Sudden appearance for some; slow-developing for others
o Recovery is more difficult for slow-developing onset
o Men are stuck earlier, more severely, and slightly more often
Prenatal environment and risk – schizophrenia
o Low birth weight
o Lack of oxygen during delivery
o Maternal prenatal nutrition
o Mid pregnancy viral infection (flu, dense population, season of birth)
Bipolar is treated with?
o Lithium
Natural salt
Monitor carefully
Deadly and fatal
Psychoanalysis
o Therapy in which a trained therapist uses psychological techniques to assist someone seeking to overcome difficulties or achieve personal growth
Psychoanalysis : Goals
o To bring patients’ repressed feelings into conscious awareness
o To help patients release energy devoted to id-ego-superego conflicts
Psychoanalysis: Techniques
o Historical reconstruction, initially through hypnosis and later through free association
o Interpretation of resistance, transference
Psychodynamic therapy
o is a view that explains personality in terms of conscious and unconscious forces, such as unconscious desires and beliefs.
o also known as insight-oriented therapy, focuses on unconscious processes as they are manifested in a person’s present behavior.
Psychodynamic Therapy Goals
o To help people understand current symptoms
o a client’s self-awareness and understanding of the influence of the past on present behavior.
o To explore and gain perspective on defended-against thoughts and feelings
Psychodynamic Therapy Techniques
o Client-centered face-to-face meetings
o Exploration of past relationship troubles to understand the orgiins of current difficulties
Humanistic Therapy Theme
Emphasis on people’s potential for self-fullfillment
To give people new insights
Humanistic Therapies Goals
To reduce inner conflicts that interfere with natural development and growth
Humanistic Therapies Techniques
Client-centered therapy
Focus on taking responsibility for feelings and actions and on present and future rather than past
Client-centered Therapy
o Carl Rogers
o Person-centered therapy focuses on a person’s conscious self-perceptions
- Most people possess resources for growth
Terms associated with client-centered therapy
Non-directive
Active listening
Unconditional positive regard
What does therapists do during person(client)-centered therapy
Foster growth by exhibiting genuineness, acceptance, and empathy
During Carl Rogers Humanistic Therapy…How is communication strengthened?
Summarize
Invite clarification
Reflect feelings
Behavior Therapies - Classical Conditioning Techniques
Counterconditioning
Exposure therapies
Systematic desensitization
Counterconditioning
Uses classical conditioning to evoke new responses to stimuli that are triggering unwanted behaviors
Exposure Therapies
o Treat anxieties by exposing people (in imagination or actual situations) to the things they fear and avoid
Systematic desensitization
o Associates a pleasant, relaxed state with gradually increasing, anxiety-triggering stimuli
Virtual reality exposure therapy
o Treats anxiety by creative electronic simulations in which people can safely face their greatest fears, such as airplane flying, spiders, or public speaking
Aversive conditioning
o Therapists gave people with a history of alcohol abuse a mixed drink containing alcohol and a drug that produces severe nausea.
o After repeated treatments, some people developed at least a temporary conditioned aversion to alcohol
Operant conditioning therapies
consequences drive behavior
Operant conditioning: Behavior modification
The desired behavior is reinforced
Undesired behavior is not reinforced and is sometimes ignored or punished
Operant Conditioning: Token economy
People earn a token for exhibiting a desired behavior and can later exchange the tokens for privileges or treats
Insight Therapists
o Assume self-awareness and psychological well-being are complementary
Psychodynamic therapist
o Expect people’s problems lessen insight into unresolved and unconscious tensions gained
Humanistic therapists
o Expect people’s problems to lessen as they get in touch with their feelings
Behavior Therapist
o Assume problem behaviors are the problems
Cognitive therapies - lost job leading to no depression
o Internal beliefs; im worthless, it’s hopeless
Cognitive therapies - lost job leading to no depression
o Internal beliefs; my boss is a jerk; I deserve something better
Cognitive Therapies
o Teach people new, more adaptive ways of thinking
o Based on the assumption that thoughts intervene between events and our emotional reactions
Beck’s Therapy for depression
Cognitive therapy
Gentle questioning seeks to reveal irrational thinking and then to persuade people to change their perceptions of their own and others actions as dark, negative, and pessimistic
People are trained to recognize and modify negative self-talk
Cognitive Therapy techniques
- reveal beliefs
- test beliefs
- change beliefs
Cognitive-Behavioral therapy
Integrative therapy that combines cognitive therapy (changing self-defeating thinking) with behavior therapy (changing behavior)
What does cognitive-behavioral therapy aim to do?
Aims to alter the way they act and the way they think
Helps people learn to make more realistic appraisals
Group therapy is conducted with?
Conducted with groups rather than individuals, providing benefits from group interactions
Group Therapy is often used when?
Client problems involve interactions with others
Family therapy treats?
- the family as a system
Family therapy views an individual’s unwanted behaviors as?
Influenced by, or directed at, other family members
Family therapy often acts as what kind of therapy?
As a preventive mental health strategy
Therapists helps family members understand how their ways of relating to one another create problems
Treatment’s emphasis is not on changing the individuals, but on changing their relationship and interactions
Biomedical therapies
o Therapy in which a trained therapist, most often a medical doctor, offers medications and other biological treatments
Eclectic approach
uses blend of therapies
Clients’ perceptions
o Client self-reports indicate that psychotherapy is effective
Critics of client self-reports
o Clients may need to justify their investment of effort and money
o Clients generally speak in positive terms of their therapists
o Clients often enter therapy in crisis
Clinicians’ perceptions
o Therapists are most aware of the failure of other therapists
Outcome research: With or without psychotherapy and after extensive research review
- people improved noticeable over time
- those not undergoing therapy often improve, but those undergoing therapy are more likely to improve
Drug Therapies
o Which is the most widely used biomedical treatments?
Drug therapies
o Include prescribed antidepressants for 27 million americans
o Involve placebo and double-blind tecniques to evaluate drug effectiveness
Brain stimulation
Electroconvulsive therapy (ECT)
Alternative neurostimulations therapies
Vagus nerve stimulation
Deep brain stimulation
Repetitive transcranial meagnetic stimulations (rTMS)
Vagus nerve stimulations
Stimulates neck nerve that sends signals to limbic system
Increases available serotonin by increasing firing rate of some neurons
Repetitive transcranial magnetic stimulation (rTMS)
Sends magnetic energy to brain surface through coiled wire held close to brain
Fewer side effects
Modest effectiveness
Deep brain stimulations
Manipulates depressed brain via pacemaker
Stimulates inhibition activity related to negative emotions and thoughts
Psychosurgery
Involves surgery that removes or destroys brain tissue in an effort to change behavior
Is irreversible
Is the leased used biomedical therapy
Lobotomy
Psychosurgical procedure once used to calm uncontrollable emotional or violent patients
Procedure cut the nerve connecting the frontal lobes to the emotion-controlling centers of the inner brain (moniz)
Today less invasive techniques are used
MRI-guided surgery in severe disorders
Electroconvulsive Therapy (ECT)
o Manipulates the brain by shocking it
o Involves administration of a general anesthetic and muscle relaxation to prevent convulsions
o Causes less memory disruption than earlier versions
o Reduces suicidal thouhgts
Behavior therapies work best for what particular problems?
o Bed-wetting, phobias, compulsions, marital problems, and sexual dysfunctions
Psychodynamic therapy works best for what particular problems?
- Depression and anxiety
Cognitive therapies works best for what particular problems?
Anxiety, depression, and post-traumatic stress disorder
Two key elements (referring to the therapist-client relationship) in effective therapy>
Trust and?
Three basic benefits for all psychotherapies
o Hope for demoralized people
o A new perspective for oneself and the world
o An empathic, trusting, caring relationship
Therapeutic lifestyle change
o Training seminars
o 12-week training with the following goals
Preventing psychological disorders
resilience
prevention
Resilience
involves personal strength that helps most people cope with stress and recover from adversity and trauma
can be seen in New Yorkers after 9/11, spinal cord injury patients, holocauset survivors, and others
Prevention
through identification and elimination of conditions that cause psychological casualties
through support of programs and providers that control or eliminate stress
Social Psychology
o Studies how we think about our social world, how other people influence our behavior, and how we relate toward other people
o “hes been under a lot of stress lately” “he honly thinks about himself. What a jerk!” depending on which attribution she makes for her husband’s outburst, this woman may respond with understanding or anger
Social psychologists
o use scientific methods to study how we think about, influence, and relate to one another
o study social forces that explain why people act differently in different situations
Personality psychologists
o Study personal traits and processes that explain why individuals may act differently in a given situation
Attribution
o An explanation (social psychology for a person’s behavior)
Fundamental attribution error
o the tendency, when analyzing others behavior, to overestimate the influence of personal traits and underestimate the effects of the situation
o most likely to occur when a stranger acts badly
o has real-life and social consequences
Example of fundamental attribution error
o Driving to school one snowy day, marco narrowly misses a car that slides through a red light. “Slow down! What a terrible driver,” he thinks to himself. Moments later, marco himself slips through an intersection and yelps, “wow! These roads are awful. The city plows need to get out here.”
Attitude most influences behavior when?
o External influences are minimal
o The attitude is stable
o The attitude is specific to the behavior
o The attitude is easily recalled
Self-serving Bias
o people’s tendency to attribute positive events to their own character but attribute negative events to external factors.
o a common type of cognitive bias that has been extensively studied in social psychology
How prejudiced are people?
o Open prejudice lessens; subtle prejudice lingers
o Can be automatic and unconscious
Stereotype
o Rationalize inequalities
o gays and lesbians cannot comfortably be themselves
o fathers are percieved as more intelligent than mothers
o more women live in poverty; 163 million “missing women”
Reasons stereotype are harmful?
They reduce one’s ability to treat each member of a group as individual
They lead to narrow expectations for behavior
They lead to faulty attributions
• Attribution theory
• Automatic prejudice
Conformity
o Conformity - Chartrand and colleagues (1999)
Demonstrated chameleon effect with college students
Automatic mimicry helps people to empathize and feel what others feel
The more we mimic, the greater our empathy, and the more people tend to like us
People are more likely to conform when they?
Are made to feel incompetent or insecure
Are in a group in which everyone else agrees
Admire the group’s status and attractiveness
Have not already committed to any response
Know that others in the group will observe our behavior
Are from a culture that strongly encourages respect for social standards
Foot-in-the-door technique
o attitudes follow behavior
o people agreeing to a small request will find it easier to later agree to a larger one
o principle works for negative and positive behavior
o cooperative actions, performed by people on sports teams feed mutual liking. Such attitudes promote positive behavior
groupthink
o mode of thinking that occurs when the desire for harmony in a decision-making group overrides a realistic appraisal of alternatives
o escalation of Vietnam war; chernobyl nuclear reactor accident; us space shuttle challenger explosion; wmd in Iraq
group polarization
o if a group is like-minded, discussion strengthens existing opinions
o racial issues: increaserd prejudice in a high-prejudice group of high school students and decreased in a low-prejudice group
deindividuation
o a loss of self-awareness and self-restraint occurring in a group situations that foster arousal and anonymity
o thrives in many different settings
o during england’s 2011 riots and looting, rioters were disinhibited by social arousal and by the anonymity provided by darkness and their hoods and masks. Later, some of those arrested expressed bewilderment over their own behavior
social loafing
o the tendency for people in a group to exert less effort when pooling their efforts toward attaining a common goal than when individually accountable
o individuals free ride on the efforts of others
automatic prejudice
o implicit racial associations
o race-influenced perceptions
o reflexive bodily response
Implicit racial associations
negative associations linked to the denial of racial prejudice
race-influenced perceptions
perceptions influenced by expectations
reflexive bodily responses
telltale signs of selective body responses to another person’s race
altruism
unselfish concern for the welfare of others
the bystander effect
o when people thought they alone heard the calls for help from a person they believed to be having an epiliptic seizure, they usually helped
o but when they thought four others were also present a third responded
Bystander intervention - necessary conditions
- (darley and latane)
notice incident
interpret event as emergency
assume responsibility for helping
Flow
o also known as zone, is the mental state of operation in which a person performing an activity is fully immersed in a feeling of energized focus, full involvement, and enjoyment in the process of the activity.
o characterized by complete absorption in what one does
Industrial-organization psychology
is the scientific study of human behavior in the workplace and applies psychological theories and principles to organization
Frustration-aggression principle
o frustration creates anger, which can spark aggression
o adversive events
Conformity experiment
o Asch’s experiment: agreeing or disagreeing with the responses of other group members
Obedience Studies
o Stanley milgram investigated the effects of punishment on learning
o Experiments involved commnands to shock someone using up to a 450 vold final level
o More than 60% followed orders
Milgram’s research: obedience was highest when?
o The person giving orders was in close proximity and perceived as a legitimate authority fiture
o The authority figure was supported by a well-known institution
o The victim was depersonalized or at a distance
o No models existed for defiance
Lessons from the conformity and obedience studies
o Strong social influences can make people conform to falsehoods or give in to curelty
o Social control and personal control interact
o Minority influence is most effective if a position is taken firmly
What do we mean by attractive?
o The answers varies by culture and over time. Some adult physical features, such as a youthful form and face, seem attractive everywhere
Factors in attraction
proximity
similarity
reciprocity of liking
intimacy
similarity
people are often attracted to others who are similar to themselves
proximity
we tend to interact most with people who are physically closer
reciprocity of liking
A tendency to like those who like us
Knowing that someone evaulates us positively promotes our attraction to that person
intimacy
Self-disclosure of personal information – based on trust, and pacing is important
Passionate love
o Two-factor theory of emotioni
o Sexual desire + a growing attachment = the passion of romantic love
Sternberg’s triangular theory of love
o Love consists of 3 parts (consummate love)
o Decision/commitment
o Intimacy
o passion
Cognitive dissonance theory
o Explains the tendency of attitudes to sometimes shift to be consistent with behavior
o Smoking even though one knows it harmful
Dissonance
we act to reduce the discomfort
Cognition
We feel when two of our thoughts clash
Cognitive dissonance: relief from tension
o We act to reduce the discomfort we feel when two of our thoughts clash
o Brain regions become active when people experience cognitive dissonance
o Through cognitive dissonance we often bring attitudes into lijne with our actions (festinger)
Prejudice
o Prejudgement
o An unfair negative attitude towaqrd some group
o Often targets different cultural, ethnic, or gender groups
Prejudice components
o Beliefs
o Emotions
o Predispositions to action (to discriminate)
Prejudice is…to discrimination is…
o Negative attitude to negative behavior
Combating prejudice
o Recognize prejudice
o Control automatic prejudice
o Increase contact among prejudice groups:
Groups should be equal in status
View each other as typical of their repective groups
Cooperative rather than competitive tasks
Contact should be informal
Promoting peace
o Research indicates that in some cases contact and cooperation can be transformational
Promoting peace - contact
Most effective when contact is free of competition and equal status exists
Contact is not always enough
Promoting peace - cooperation
Cooperative contact, not conflict alone, reduced conflict
Cooperative learning can maintain or enhance student achievement
Apply to activities focused on making friends or former enemies
Industrial-organization psychologists focus
Identify training and development needs;
Design and optimize job and work and quality of work life;
Formulate and implement training programs and evaluate their effectiveness;
Coach employees;
Develop criteria to evaluate performance of individuals and organizations; and
Assess consumer preferences, customer satisfaction and market strategies.
Pyschological Disorders
A syndrome marked by a clinically significant disturbance in a person’s thoughts, feelings, or behaviors
- Sam’s friends are starting to worry about him. Normally energetic and fun-loving, Sam has become withdrawn and sullen. He has lost weight, is constantly tired, and hasn’t been showing up to lacross practice or to his fraternity meetings. In his conversations with others, he expresses feelings of doubt and unworthiness, and seems to be entertaining suicidal thoughts.
Major Depressive Disorder
- Frank awoke one morning and suddenly realized that he had another name and a family in another state. He had no idea how he came to be living his present life.
Dissociative Fugue
- Jean sometimes stays in one position for long periods of time, is withdrawn from others, and tends to exhibit odd behaviors.
Schizophrenia
- Because Amy feels “dirty” a lot of the time, she spends much of her day at the sink, washing and rewashing her hands hundreds of times until they are red and raw.
Obsessive-Compulsive Disorder
- While teaching her class one day, Theresa suddenly begins having difficulty breathing. Her heart starts pounding wildly, and she feels weak and dizzy. She feels as if she’s having a heart attack and is honestly afraid that she’s going to die in the next minute or two. (Assume Theresa is not having a heart attack.)
Panic attack Disorder
- Shannon’s moods seem to swing abruptly, and she often seems unable to control her impulses. She has had many sexual encounters and often complains of boredom, though she is seldom alone and often caught up in very intense, stormy relationships. Her friends are on edge around her because of her Jekyll-Hyde behavior.
Borderline Personality Disorder
- Although Karina was not personally injured in the earthquake, the experience was a terrifying one and her house was badly damaged. She has frequent nightmares about earthquakes, and even when awake she sometimes gets flashes as if she’s reliving the experience. The slightest noise or movement around her causes her heart to pound rapidly.
Post Traumatic Stress Disorder
- Matthew, although a good-looking guy, is so preoccupied with what he thinks is his large, unsightly nose that he is unable to realistically evaluate his own looks and often talks with his hand in front of his face. He will likely have plastic surgery some day.
Body Dysmorphic Disorder
- For over six months now, Julie can’t stop herself from worrying about everything, and complains of headaches, heart palpitations, and insomnia. She’s constantly fretting about something.
Generalized Anxiety Disorder
