Mental Disorders

• Basic concepts
• What is a mental disorder?
• Perspectives on mental disorders
• Anxiety Disorders

• Schizophrenia
• Eating Disorders

• Mental disorder = maladaptive psychological process
• Maladaptive psychological process must:
• Involve clinically significant distress and/or impaired functioning
• Have an internal source
• Be manifested involuntarily

Diasthesis-stress model
The fine line between “normal” and “abnormal”

Prevalence

Perspectives

• Biological/Medical Model
• genetic disorder
• neurochemical dysfunction
• disease
• Cognitive, Behavioral, Psychodynamic Perspectives
• Interaction with the environment
• [Conflicts among id, ego, superego]
• Sociocultural Perspective
• Interaction with the larger environment -- culture

Eating Disorders

• Anorexia Nervosa
• Bulimia Nervosa
• Compulsive Overeating

• Refusal to maintain body weight (< 85% normal weight or BMI < 17.5)
• Intense fear of gaining weight 
• Undue influence of body image on self evaluation
• Amenorrhoea (in postmenarcheal women)

• Comorbidity:
• Depression
• Anxiety

Prevalence

• Third most common chronic illness in adolescent females
• Estimated to affect up to 5% in adolescent females
• Rate increasing in males and females

Meeting the criteria for a mental disorder

• Clinically significant distress and/or impaired functioning
• Life-threatening medical disorder
• Social isolation
• Internal source
• No medical explanation for weight loss
• Be manifested involuntarily
• Even during treatment, anorectics cannot eat

Biological/Medical Perspective

• Genetic link
• Anorexia in 9 of 16 monozygotic twins but 1 of 14 in dizygotic twins
• 20% of anorectics have family member with eating disorder, compared with 6% for other mental disorders
• Neurochemical disorder
• Abnormally high levels of endogenous opioids in CSF
• Disease link
• Sudden onset OCD and/or anorexia following strep infection

Psychodynamic Perspective

• Inability to accept developing sexuality and independence
• Fear of becoming like her mother
• Reaction to controlling parents

Behavioural Perspective: Activity Anorexia

• Anorexia is induced and maintained by abnormal levels of exercise
• Intense physical activity central, not symptomatic
• Adaptation gone awry:
• Limited food source
• Travel great distance at great speed to find more food
• Something goes wrong: Exercise, not obtaining food, becomes reinforcing

Epling, Pierce, & Stefan (1983)

Sociocultural Perspective

• Thin society
• 1950s: 7% men, 14% women reported dieting
• 1990s: 24% men, 40% women report dieting
• Eating disorders equal in all social classes
• Eating disorders equal among Whites and African Americans

• Gender Differences