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Introduction to Psychology

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Title: Introduction to Psychology


1
PSYCHOLOGICAL DISORDERS
2
Rate this person using the following scale1
Basically OK Psychotherapy is not
necessary2Mild Disturbance. Psychotherapy
should be considered3 Significant disturbance.
Psychotherapy is definitely required4 Severe
disturbance. Hospitalize!
  • Jim was vice president of the freshman class at a
    local college and played on the schools football
    team. Later that year he dropped out of these
    activities and gradually became more and more
    withdrawn from friends and family. Neglecting to
    shave and shower, he began to look dirty and
    unhealthy. He spent most of his time alone in his
    room and sometimes complained to his parents that
    he heard voices in the curtains and in the
    closet. In his sophomore year he dropped out of
    school entirely. With increasing anxiety and
    agitation, he began to worry that the Nazis
    were plotting to kill his family and kidnap him.

3
Rate this person using the following scale1
Basically OK Psychotherapy is not
necessary2Mild Disturbance. Psychotherapy
should be considered3 Significant disturbance.
Psychotherapy is definitely required4 Severe
disturbance. Hospitalize!
  • Mary is a 30 year old musician who is very
    dedicated and successful in her work as a teacher
    in a local high school and as a part time member
    of local musical groups. Since her marriage five
    years ago, which ended in divorce after six
    months, she has dated very few men. She often
    worries that her time is running out for
    establishing a good relationship with a man,
    getting married, and raising a family. Her
    friends tell her that she gets way too anxious
    around men, and that she needs to relax a little
    in general.

4
Its All a Matter of Degree
5
Historical Perspective
  • Perceived Causes
  • movements of sun or moon
  • lunacy--full moon
  • evil spirits
  • Ancient Treatments
  • exorcism, caged like animals, beaten, burned,
    castrated, mutilated, blood replaced with
    animals blood

6
Trephination-holes drilled into skulls ostensibly
to let evil spirits to escape (found in
prehistoric human remains during the Neolithic
times)
Procedure had survived and continued through the
Middle Ages and Renaissance.
7
Psychological Disorders
  • Philippe Pinel (1745-1846)
  • French reformer insisted that madness was not
    demon possession, but a sickness in response to
    severe stresses and inhumane conditions.
  • Proposed moral treatment whereby doctors
    would unchain the patients and talk to them.

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Psychological Disorders
  • Medical Model
  • concept that diseases have physical causes
  • can be diagnosed, treated, and in most cases,
    cured
  • assumes that these mental illnesses can be
    diagnosed on the basis of their symptoms and
    cured through therapy, which may include
    treatment in a psychiatric hospital

10
Psychological Disorders
  • Thomas Szasz
  • believes that mental illnesses are socially, not
    medically, defined.

11
Psychological Disorders
  • Psychological Disorder
  • a harmful dysfunction in which behavior is
    judged to be
  • atypical--not enough in itself
  • disturbing--varies with time and culture
  • maladaptive--harmful
  • unjustifiable--sometimes theres a good reason
  • Three Ds dysfunction, deviance,
  • distressful

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Psychological Disorders--Etiology
  • DSM-IV
  • American Psychiatric Associations Diagnostic and
    Statistical Manual of Mental Disorders (Fourth
    Edition)
  • a widely used system for classifying
    psychological disorders
  • presently distributed as DSM-IV-TR (text revision)

14
Labeling Psychological Disorders
  • Once we label a person, we view that person
    differently.
  • Labels create preconceptions that guide our
    perceptions and our interpretations.

15
Labeling Psychological Disorders (David Rosenhan)
  • David Rosenhan and seven others went to mental
    hospital admissions offices, complaining of
    hearing voices that were saying empty,
    hollow, and thud. Apart from this complaint
    and giving false names and occupations, they
    answered all the questions truthfully. All eight
    were diagnosed as mentally ill.

16
Psychological Disorders
  • Bio-Psycho-Social Perspective
  • assumes that biological, sociocultural, and
    psychological factors combine and interact to
    produce psychological disorders

17
Psychological Disorders
18
Prevalence
  • Approximately 48 of adults experienced symptoms
    at least once in their lives
  • Approximately 80 who experienced symptoms in the
    last year did NOT seek treatment
  • Most people seem to deal with symptoms without
    complete debilitation
  • Women have higher prevalence of depression and
    anxiety
  • Men have higher prevalence of substance abuse and
    antisocial personality disorder

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Psychological Disorders- Etiology
  • Neurotic Disorder (term seldom used now)
  • usually distressing but that allows one to think
    rationally and function socially
  • Psychotic Disorder
  • person loses contact with reality
  • experiences irrational ideas and distorted
    perceptions

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Anxiety Disorders
  • Anxiety Disorders
  • distressing, persistent anxiety or maladaptive
    behaviors that reduce anxiety
  • Generalized Anxiety Disorder
  • person is tense, apprehensive, and in a state of
    autonomic nervous system arousal

23
Model of Development of GAD
  • GAD has some genetic component
  • Related genetically to major depression
  • Childhood trauma also related to GAD

24
Generalized Anxiety Disorder (GAD)
  • More or less constant worry about many issues
  • The worry seriously interferes with functioning
  • Physical symptoms
  • headaches
  • stomach aches
  • muscle tension
  • irritability

25
Anxiety Disorders
  • Panic Disorder
  • marked by a minutes-long episode of intense dread
    in which a person experiences terror and
    accompanying chest pain, choking, or other
    frightening sensation

26
Anxiety Disorders
  • Phobia
  • persistent, irrational fear of a specific object
    or situation
  • Obsessive-Compulsive Disorder
  • unwanted repetitive thoughts (obsessions) and/or
    actions (compulsions)

27
Phobias
  • Intense, irrational fears that may focus on
  • Natural environmentheights, water, lightening
  • Situationflying, tunnels, crowds, social
    gathering
  • Injuryneedles, blood, dentist, doctor
  • Animals or insectsinsects, snakes, bats, dogs

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Anxiety Disorders
  • Common and uncommon fears

31
Anxiety Disorders
32
Anxiety Disorders
  • PET Scan of brain of person with Obsessive/
    Compulsive disorder
  • High metabolic activity (red) in frontal lobe
    areas involved with directing attention

33
The Learning Perspective
  • The Learning Perspective
  • sees anxiety disorders as a product of learned
    helplessness or fear conditioning
  • Fear Conditioning
  • Researchers have linked general anxiety with
    classical conditioning of fear.

34
The Learning Perspective
  • Stimulus Generalization
  • Conditioned fears may remain long after we
    have forgotten the experiences that produced
    them.
  • Stimulus generalization may occur when a
    person who fears heights after a fall may be
    afraid of airplanes without ever having flown.

35
The Learning Perspective
  • Reinforcement
  • Once phobias and compulsions arise,
    reinforcement helps maintain them. Avoiding or
    escaping the feared situation reduces anxiety,
    thus reinforcing the phobic behavior.

36
The Learning Perspective
  • Observational Learning
  • We learn fear through observing others.
    Parents transmit their fears to their children.

37
The Biological Perspective
  • The Biological Perspective
  • Considers possible evolutionary, genetic, and
    physiological influences.
  • Natural Selection
  • Phobias focus on dangers faced by our
    ancestors. Compulsive acts typically exaggerate
    behaviors that contributed to our species
    survival.

38
The Biological Perspective
  • Genes
  • Some people seem genetically predisposed to
    particular fears and high anxiety. Identical
    twins often develop similar phobias, even when
    raised separately.

39
The Biological Perspective
  • Physiology
  • General anxiety, panic attacks, and even
    obsessions and compulsions are biologically
    measurable as an overarousal of brain areas
    involved in impulse control and habitual
    behaviors. (PET scans)

40
Post-Traumatic Stress Disorder
  • Post-Traumatic Stress Disorder Traumatic stress
    (experiencing or witnessing severely threatening,
    uncontrollable events with a sense of fear,
    helplessness, or horror) can produce PTSD,
    symptoms of which include haunting memories and
    nightmares, numbed social withdrawal, jumpy
    anxiety, and insomnia.

41
POST-TRAUMATIC STRESS DISORDER
  • Some experts estimate that as many as 200,000
    World War II veterans continue to suffer from
    PTSD.
  • Currently, about 19 of Iraqi veterans and 11 of
    Afghanistan veterans return home with mental
    health problems.
  • Children can also suffer from PTSD

42
Somatoform Disorders
  • Psychological disorders in which the symptoms
    take a somatic (bodily) form without apparent
    physical cause.
  • In Freuds day, called hysteria. In 1970s,
  • hysteria as an independent diagnostic entity
  • was deleted from the official manuals of
  • medical diagnosis.

43
Somatoform Disorders
  • Conversion Disorders
  • a rare somatoform disorder in which a person
    experiences very specific genuine physical
    symptoms for which no physiological basis can be
    found.

44
Somatoform Disorders
  • Hypochondriasis
  • a somatoform disorder in which a person
    misinterprets normal physical sensations as
    symptoms of a disease.

45
Dissociative Disorders
  • conscious awareness becomes separated
    (dissociated) from previous memories, thoughts,
    and feelings
  • Dissociative Identity Disorder
  • rare dissociative disorder in which a person
    exhibits two or more distinct and alternating
    personalities
  • formerly called multiple personality disorder

46
Dissociative Disorders
Amnesia
Fugue
Memories related to a trauma disappear and the
person starts life all over.
Memories related to a trauma disappear.
Identity Disorder
A person will have several personalities that
are unique.
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Dissociative Amnesia
  • Also known as psychogenic amnesia
  • Memory loss the only symptom
  • Often selective loss surrounding traumatic events
  • person still knows identity and most of their
    past
  • Can also be global
  • loss of identity without replacement with a new
    one

49
Dissociative Amnesia
  • Margie and her brother were recently victims of a
    robbery. Margie was not injured, but her brother
    was killed when he resisted the robbers. Margie
    was unable to recall any details from the time of
    the accident until four days later.

50
Dissociative Fugue
  • Also known as psychogenic fugue
  • Global amnesia with identity replacement
  • leaves home
  • develops a new identity
  • apparently no recollection of former life
  • called a fugue state
  • If fugue wears off
  • old identity recovers
  • new identity is totally forgotten

51
Dissociative Fugue
  • Jay, a high school physics teacher in New York
    City, disappeared three days after his wife
    unexpectedly left him for another man. Six
    months later, he was discovered tending bar in
    Miami Beach. Calling himself Martin, he claimed
    to have no recollection of his past life and
    insisted that he had never been married.

52
Dissociative Identity Disorder
(DID)
  • Originally known as multiple personality
    disorder
  • 2 or more distinct personalities manifested by
    the same person at different times
  • VERY rare and controversial disorder
  • Examples include Sybil, Trudy Chase, Chris
    Sizemore (Eve)
  • Has been tried as a criminal defense

53
Dissociative Identity Disorder
  • Pattern typically starts prior to age 10
    (childhood)
  • Most people with disorder are women
  • Most report recall of torture or sexual abuse as
    children and show symptoms of PTSD

54
Dissociative Identity Disorder (DID)
  • Norma has frequent memory gaps and cannot
    account for her whereabouts during certain
    periods of time. While being interviewed by a
    clinical psychologist, she began speaking in a
    childlike voice. She claimed that her name was
    Donna and that she was only six years old.
    Moments later, she seemed to revert to her adult
    voice and had no recollection of speaking in a
    childlike voice or claiming that her name was
    Donna.

55
Causes of Dissociative Disorders?
  • Repeated, severe sexual or physical abuse
  • However, many abused people do not develop DID
  • Combine abuse with biological predisposition
    toward dissociation?
  • people with DID are easier to hypnotize than
    others
  • may begin as series of hypnotic trances to cope
    with abusive situations

56
The DID Controversy
  • Some curious statistics
  • 193060 2 cases per decade in USA
  • 1980s 20,000 cases reported
  • many more cases in US than elsewhere
  • varies by therapistsome see none, others see a
    lot
  • Is DID the result of suggestion by therapist and
    acting by patient?

57
Moderate depression that will go away without
therapy
Restlessness, inability to concentrate, and
rapid speech
Dysthymic Disorder
Mania
Mood Disorders
Major Depression
Bipolar
Lasting from a couple of weeks to months
Swings of mania and depression
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Major Depression
  • A mood disorder characterized by extreme and
    persistent feelings of despondency, worthlessness
    and hopelessness
  • Prolonged, very severe symptoms
  • Passes without remission for at least 2 weeks
  • Global negativity and pessimism
  • Very low self-esteem

60
Symptoms of Major Depression
  • Emotional sadness, hopelessness, guilt, turning
    away from others
  • Behavioral tearfulness, dejected facial
    expression, loss of interest in normal
    activities, slowed movements and gestures,
    withdrawal from social activities
  • Cognitive difficulty thinking and concentrating,
    global negativity, preoccupation with
    death/suicide
  • Physical appetite and weight changes, excess or
    diminished sleep, loss of energy, global anxiety,
    restlessness

61
Dysthymic Disorder
  • Chronic, low-grade depressed feelings that are
    not severe enough to be major depression
  • May develop in response to trauma, but does not
    decrease with time
  • Can have co-existing major depression

62
Seasonal Affective Disorder
(SAD)
  • Cyclic severe depression and elevated mood
  • Seasonal regularity
  • Unique cluster of symptoms
  • intense hunger
  • gain weight in winter
  • sleep more than usual
  • depressed more in evening than morning

63
Prevalence and Course
  • Most common of psychological disorders
  • Women are twice as likely as men to be diagnosed
    with major depression
  • Untreated episodes can become recurring and more
    serious
  • Seasonal affective disorder (SAD)onset with
    changing seasons

64
Mood Disorders
  • Bipolar Disorder (Manic depression)
  • a mood disorder in which the person alternates
    between the hopelessness and lethargy of
    depression and the overexcited state of mania
  • formerly called manic-depressive disorder
  • Manic Episode
  • a mood disorder marked by a hyperactive, wildly
    optimistic state

65
Prevalence and Course
  • Bipolar Disorder
  • Onset usually in young adulthood
  • (early twenties)
  • Mood changes more abrupt than in major
    depression
  • No sex differences in rate of bipolar disorder
  • Commonly recurs every few years
  • Can often be controlled by medication (lithium)

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  • Canadian depression rates

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Suicide
  • National differences
  • England, Italy, Spain little more than half
    rate of Canada, U.S. Australia while Austria and
    Finland higher
  • Racial differences-
  • white Americans about twice as likely as black
    Americans
  • Gender differences-
  • More women attempt suicide while men are four
    times more likely to succeed

70
  • PET scans show that brain energy consumption
    rises and falls with emotional switches

71
  • Altering any one component of the
    chemistry-cognition-mood circuit can alter the
    others

72
  • The vicious cycle of depression can be broken at
    any point

73
Explaining Mood Disorders
  • Neurotransmitter theories (Biology)
  • dopamine
  • norepinephrine
  • serotonin
  • Genetic component
  • more closely related people show similar
    histories of mood disorders

74
Causes
  • Use linkage analysis- look for genes that may put
    people at risk for depression and points to
    chromosome neighborhoods
  • Association studies- look for correlations among
    these genes and a larger population trait.
  • Norepinephrine and serotonin are both scarce in
    depression and in excess in mania
  • Lower levels of omega-3 fatty acid
  • Left frontal lobe less active during depressed
    states

75
Situational Bases for Depression
  • Positive correlation between stressful life
    events and onset of depression
  • Does life stress cause depression?
  • Most depressogenic life events are losses
  • spouse or companion
  • long-term job
  • health
  • income

76
Cognitive Bases for Depression
  • A.T. Beck depressed people hold pessimistic
    views of
  • themselves
  • the world
  • the future
  • Depressed people distort their experiences in
    negative ways
  • exaggerate bad experiences
  • minimize good experiences

77
Cognitive Bases for Depression
  • Hopelessness theory
  • depression results from a pattern of thinking
  • person loses hope that life will get better
  • negative experiences are due to stable, global
    reasons
  • e.g., I didnt get the job because Im stupid
    and inept vs. I didnt get the job because the
    interview didnt go well

78
MOOD DISORDERS
  • MANIA Symptoms
  • Elation, euphoria, desire for action
  • Impatience, distractibility
  • Inflated self-esteem
  • Grandiosity
  • Impulsiveness
  • Hyperactivity
  • Decreased need for sleep
  • Sexual indiscretion
  • Increased appetite

79
Flight of ideas
-a nearly continuous flow of rapid speech that
jumps from topic to topic. Most commonly seen
in manic episodes.
80
Schizophrenia
  • Schizophrenia
  • literal translation split mind
  • a group of severe disorders characterized by
  • disorganized and delusional thinking
  • disturbed perceptions
  • inappropriate emotions and actions

81
What is Schizophrenia?
  • Comes from Greek meaning split and mind
  • split refers to loss of touch with reality
  • not dissociative state
  • not split personality
  • Equally split between genders, males have
    earlier onset
  • 18 to 25 for men
  • 26 to 45 for women

82
IF YOU TALK TO GOD, YOURE PRAYING IF
GOD TALKS TO YOU, YOU HAVE
SCHIZOPHRENIA Thomas Szasz
83
Schizophrenic Disorders
Symptoms
Disorganized Thoughts Hallucinations Delusions Gar
bled Speech Word Salad Clanging
84
Symptoms of Schizophrenia
  • Positive symptoms
  • hallucinations
  • delusions
  • Negative symptoms
  • absence of normal cognition or affect (e.g., flat
    affect, poverty of speech)
  • Disorganized symptoms
  • disorganized speech (e.g., word salad)
  • disorganized behaviors

85
Frequency of positive and negative symptoms in
individuals at the time they were hospitalized
for schizophrenia. Source Based on data
reported in Andreasen Flaum, 1991.
86
Symptoms of Schizophrenia
  • Chronic or process
  • schizophrenia is a slow-developing process
    recovery is doubtful.
  • Acute or reactive
  • schizophrenia develops rapidly recovery is
    much more likely.

87
Schizophrenia
  • Delusions
  • false beliefs, often of persecution or grandeur,
    that may accompany psychotic disorders
  • In a psychiatrist's waiting room two patients are
    having a conversation. One says to the other,
    "Why are you here?"The second answers, "I'm
    Napoleon, so the doctor told me to come
    here."The first is curious and asks, "How do you
    know that you're Napoleon?"The second responds,
    "God told me I was."At this point, a patient on
    the other side of the room shouts, "NO I DIDN'T!"

88
Symptoms of Schizophrenia
  • Delusions of persecution
  • theyre out to get me
  • paranoia
  • Delusions of grandeur
  • God complex
  • megalomania
  • Delusions of being controlled
  • the CIA is controlling my brain with a radio
    signal

89
Symptoms of Schizophrenia
  • Hallucinations
  • hearing or seeing things that arent there
  • contributes to delusions
  • command hallucinations voices giving orders
  • Disorganized speech
  • Over-inclusionjumping from idea to idea without
    the benefit of logical association
  • Paralogicon the surface, seems logical, but
    seriously flawed
  • e.g., Jesus was a man with a beard, I am a man
    with a beard, therefore I am Jesus

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Disorganized Thinking
  • Word Salad
  • jumping from one idea to another even within
    sentences.
  • Clang Associations
  • rhyming the last word of a sentence.

92
Disorganized Thinking
93
Symptoms of Schizophrenia
  • Disorganized behavior and affect
  • behavior is inappropriate for the situation
  • e.g., wearing sweaters and overcoats on hot days
  • affect is inappropriately expressed
  • flat affectno emotion at all in face or speech
  • inappropriate affectlaughing at very serious
    things, crying at funny things
  • catatonic behavior
  • unresponsiveness to environment, usually marked
    by immobility for extended periods

94
Schizophrenia
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Schizophrenia
97
Chemical Factors in Schizophrenia
1. Dopamine is a neurotransmitter found in the
brain.
2. Schizophrenics have very high levels of
dopamine.
3. They report that they feel agitated, talk
rapidly, and their thoughts are racing.
4. Some schizophrenics report that lower levels
of dopamine make them feel better.
98
The Dopamine Theory
  • Drugs that reduce dopamine reduce symptoms
  • Drugs that increase dopamine produce symptoms
    even in people without the disorder
  • Theory Schizophrenia is caused by excess
    dopamine
  • Dopamine theory not enough other
    neurotransmitters involved as well

99
Genetic Factors
  • 1 in 100 odds of any person being diagnosed with
    schizophrenia.
  • 1 in 10 chance among those who have an
    afflicted sibling or parent.
  • 1 in 2 chance among those who have an
    afflicted identical twin.

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Schizophrenia
102
Biological Bases of Schizophrenia
  • Other congenital influences
  • difficult birth (e.g., oxygen deprivation)
  • prenatal viral infection
  • Brain chemistry
  • neurotransmitter excesses or deficits
  • dopamine theory

103
Other Biological Factors
  • Brain structure and function
  • enlarged cerebral ventricles and reduced neural
    tissue around the ventricles
  • PET scans show reduced frontal lobe activity
  • Early warning signs
  • nothing very reliable has been found yet
  • certain attention deficits can be found in
    children who are at risk for the disorder
  • Fathers ageolder men are at higher risk for
    fathering a child with schizophrenia

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Family Influences on Schizophrenia
  • Family variables
  • parental communication that is disorganized,
    hard-to-follow, or highly emotional
  • expressed emotion
  • highly critical, over-enmeshed families

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Cultural Differences in Schizophrenia
  • Prevalence of symptoms is similar no matter what
    the culture
  • Less industrialized countries have better rates
    of recovery than industrialized countries
  • families tend to be less critical of the patients
  • less use of antipsychotic medications, which may
    impair full recovery
  • think of it as transient, rather than chronic and
    lasting disorder

108
Summary of Schizophrenia
  • Many biological factors seem involved
  • heredity
  • neurotransmitters
  • brain structure abnormalities
  • Family and cultural factors also important
  • Combined model of schizophrenia
  • biological predisposition combined with
    psychosocial stressors leads to disorder
  • Is schizophrenia the maladaptive coping behavior
    of a biologically vulnerable person?

109
Personality Disorders
  • Personality Disorders
  • disorders characterized by inflexible and
    enduring behavior patterns that impair social
    functioning
  • usually without anxiety, depression, or delusions

110
Personality Disorders
Borderline Personality Disorder
These people have unstable and intense
relationships with others. They are dependent on
others and yet, sabotage those relationships.
They have problems controlling their impulses
their perceptions and thoughts are distorted.
111
Borderline Personality Disorder
  • Chronic instability of emotions, self-image,
    relationships
  • Self-destructive behaviors
  • Intense fear of abandonment and emptiness
  • Possible history of childhood physical,
    emotional, or sexual abuse
  • 75 of diagnosed cases are women

112
Paranoid Personality Disorder
  • Pervasive mistrust and suspiciousness of others
    are the main characteristic
  • Distrustful even of close family and friends
  • Reluctant to form close relationships
  • Tend to blame others for their own shortcomings

113
Histrionic Personality Disorder
  • displays a shallow, attention-getting
    emotionality.
  • Histrionic individuals go to great length to
    gain others praise and reassurance.

114
Narcissistic Personality Disorder
  • exaggerate their own importance, aided by success
    fantasies.
  • They find criticism hard to accept, often
    reacting with rage or shame.

115
  • Antisocial Personality Disorder
  • disorder in which the person (usually man)
    exhibits a lack of conscience for wrongdoing,
    even toward friends and family members
  • may be aggressive and ruthless or a clever con
    artist
  • These people consistently come into conflict with
    the law and show little or no concern, guilt, or
    anxiety.

116
Personality Disorders
  • PET scans illustrate reduced activation in a
    murderers frontal cortex

117
Personality Disorders
118
Rates of Psychological Disorders
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