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Module 1 self-study questions (and answers):
1. What is the relationship between mental illness and the person’s likelihood of being violent?
a. There is no relationship between mental illness and a person’s likelihood of being violent. People with mental illnesses are no more likely to be violent than anyone else. (p. 5)

2. The author of your textbook refers to the evolutionary perspective on psychopathology. How does that perspective view psychopathology?
a. The evolutionary perspective views psychopathology in terms of how adaptive behaviors are. A problematic behavior may provide an advantage directly to the individual, or it may be secondary to another process that is advantageous to the individual. (p. 8)

3. Mental health professionals once viewed disordered behavior from the biological perspective, but now they take the biopsychosocial perspective. How does the biopsychosocial perspective differ from the original biological perspective?
a. The biopsychosocial perspective argues that social, psychological, and behavioral factors play as much a role in illness as biological factors. (p. 9)

4. Schizophrenia tends to appear at about the same age in cultures all over the world, and has about the same prevalence all over the world. What do these two things say about the relative influences of genetics and culture on the appearance of schizophrenia?
a. When a disorder appears at about the same time and with the same prevalence all over the world, it usually suggests that genetics is the major contributor to its appearance rather than culture. (p. 11)

5. When we’re considering the survival advantages and disadvantages of human behaviors, what environment do we have to consider rather than the current human technological environment?
a. In considering survival advantages and disadvantages of human behaviors, we have to consider the ancient environments in which humans evolved, not our current environments. (p. 13)

6. What are three characteristics of the concept of psychopathology that enable us to identify those who are mentally ill?
a. Mentally ill people show behaviors that are maladaptive, that cause distress to the self and to others, that violate cultural and statistical norms, that are irrational or show difficulty connecting to the environment, or that are dangerous to the self and others. (Video for Module 1)

7. Very early Greeks attributed mental illness to possession by the gods. To what did Ancient Greeks such as Pythagoras and Hippocrates attribute mental illness?
a. Pythagoras and Hippocrates attributed mental illness as well as intellect to the brain. (p. 25)

8. What were the 4 humors that were believed for many years to cause disease in humans when out of balance?
a. The 4 humors were yellow bile, black bile, blood, and phlegm. (p. 26)

9. What famous book published in the 1480s attributed mental and physical illness to possession by witches?
a. The book was Malleus Maleficarum, or "The Hammer of the Witches." (p. 27)

10. How do most neuroscientists view the mind-body problem these days?
a. Modern day neuroscientists suggest that the mind results from functioning of the brain, so the mind and body are not distinct from each other. (p. 29)

11. What are the different functions of the white and gray matter of the brain?
a. The white matter consists mostly of axons, which carry neural signals throughout the brain. The gray matter consists mostly of dendrites and cell bodies, which lack myelin and thus are darker in color. (p. 30)

12. What is the difference between the gyri and the sulci of the brain?
a. Gyri are the bumps or bulges between the wrinkles in the brain, and the sulci are the grooves or wrinkles themselves. (p. 30)

13. Paul Broca and Carl Wernicke were among the first people to document specific functions of specific sections of the brain. What are the locations and functions of Broca’s and Wenicke’s areas?
a. Broca’s area is in the left frontal lobe in most people, and is engaged in language production. Wernicke’s area is in the left temporal lobe in most people, and is engaged in language understanding. (p. 33)

14. What is Darwin’s term for the process by which successful characteristics, including successful behavioral characteristics, come to be more common over time than unsuccessful characteristics?
a. Darwin called this process natural selection. (p. 35)

15. What 19th century French physician is noted for having described a large number of brain disorders, including Parkinson’s disease, Tourette’s syndrome, and amyotrophic lateral sclerosis?
a. Jean Martin Charcot was the French physician who discovered these disorders. (p. 36)

16. How were mental patients in England’s Bethlehem hospital (popularly known as Old Bedlam) treated?
a. Patients in Bethlehem Hospital were treated cruelly. They were often chained to the walls and deprived of food and clothing. In the 1700s people visited Bethlehem Hospital like they would a zoo, paying a small fee to walk through and view the insane people. (p. 37)

17. What revolutionary change did Vincenazo Chiarugi and Phillipe Pinel institute in mental hospitals in Italy and in France in the late 1700s?
a. They independently removed the chains from the mentally ill, and helped institute humane treatment of patients. (p. 38)

18. What events led to the wholesale closing of mental hospitals in the US between the 1950s and the 1970s?
a. The closing of mental hospitals in the US was primarily due to the discovery of antipsychotic medications and to the shift in mental treatment to the community-based treatment model. (pp. 38-39)

19. What notorious problem arose as a result of the wholesale closing of mental hospitals in the US and other developed countries?
a. Closing of the mental hospitals resulted in increases in homelessness and in the number of mentally ill people in jails and prisons. (p. 39)

20. What theorist founded the psychodynamic approach to mental treatment?
a. Psychodynamics was founded by Sigmund Freud. (p. 42)

21. Psychodynamics argues that higher level cortical processes inhibit lower level processes. This is known as what psychological phenomenon that is central to psychodynamics?
a. This process is known as repression. (p. 43)

22. Psychodynamic therapists have patients engage in free association. What does that mean?
a. Free association involves the patient letting their mind drift and saying whatever comes to mind. (p. 43)

23. Psychodynamic therapists examine what clients are unwilling to say and interpretations clients are unwilling to accept. This is known as analysis of what?
a. This is the process of analysis of resistance. (p. 43)

24. Psychodynamic therapists also examine transference. What is transference?
a. In transference, the client starts seeing the therapist as standing in for past conflicts and for significant figures in the client’s life. (p. 44)

25. How does the existential/humanistic perspective on therapy differ from psychodynamics?
a. Existential/humanistic therapists focus on free will and on helping the client find meaning in life. They also focus on maintaining health rather than curing sickness. (p. 45)

26. What are the three aspects of client-centered or person-centered therapy?
a. Person-centered therapy focuses on empathic understanding of the client, unconditional positive regard, and genuineness and congruence. (p. 46)

27. What is the top-most level of Maslow’s hierarchy of needs?
a. The top-most level of Maslow’s hierarchy of needs is the need for self-actualization. (p. 47)

28. What are the three phases of emotion-focused therapy?
a. The three phases of emotion-focused therapy are bonding and awareness, evocation and exploration, and transformation and generation of alternatives. (p. 48)

29. Behavioral therapists argue that involuntary reactions to stimuli such as fears are created through what famous process?
a. Behavioral therapists attribute involuntary reactions to stimuli such as fears to classical conditioning. (p. 50)

30. What famous behaviorist argued for treating problem behavior by reinforcing the behaviors we wanted to increase in frequency and blocking the rewards for behaviors we wanted to have decrease?
a. That behaviorist was B. F. Skinner. (p. 50)

31. To what do cognitive therapists like Aaron Beck attribute psychological disturbances?
a. Cognitive therapists argue that psychological problems arise from distorted or dysfunctional thinking. (p. 51)

32. What are the three components of Beck’s cognitive triad?
a. Beck’s cognitive triad involves negative views of the self, negative views about the world, and negative views about the future. (p. 51)

33. How does the family resemblance model view abnormality?
a. The family resemblance model argues that abnormal behaviors resemble each other the way that members of a family resemble each other. No one quality determines if a behavior is abnormal or not. Rather, the more factors one gets together and the vivid those factors are, the more likely the person is mentally ill. (Module 1 video)
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Module 2 self-study questions (and answers):
1. In determining which disorders tend to co-occur with other disorders, two clusters of disorders have been found. What are the two clusters, and what kinds of disorders do each include?
a. The co-occurring clusters are internalizing disorders, such as anxiety and depression, and externalizing disorders, such as conduct disorder, antisocial personality disorder, oppositional defiant disorder, and substance abuse. (p. 60)

2. What is the document published by the American Psychiatric Association that lists the criteria for identifying and classifying mental illnesses?
a. That document is the Diagnostic and Statistical Manual of Mental Disorders, version 5, also known as the DSM-5. (p. 60)

3. Drugs that cause pleasure often involve dopamine release in what brain structure?
a. Drugs that cause pleasure generally involve dopamine release in the nucleus accumbens. (p. 61)

4. Neurological studies of brain activity have found that cognitive treatments for depression affect brain functioning differently than drug treatments for depression. In what fundamental way do the two treatments affect brain functioning differently?
a. Cognitive therapy appears to increase frontal lobe activity in depressed people, whereas drug therapies appear to reduce excessive emotional responsiveness that appears to originate from the amygdala. (p. 61)

5. Your text points out that the neck vertebrae in giraffes are created by the same genes that create the neck vertebrae in turtles and humans. So what differs between these species that causes their necks to be so different?
a. The factor that causes vertebrae to end up so differently in different animals even though they’re created by the same genes is the regulation of the genes—the mechanisms that determine which genes are turned on and off at what times. (p.63)

6. What part of a neuron receives signals from other cells, and what part transmits those signals to other cells?
a. Dendrites received neural signals, and send those signals down axons, which pass the signals on to other cells. (p. 66)

7. What is the name of the insulating material that surrounds axons and speeds neurotransmission?
a. The insulating material surrounding the axons of neurons is known as myelin. (p.66)

8. Most drugs used to treat mental illnesses affect neurons in what way?
a. Drugs used to treat mental illnesses influence neurotransmitter functioning at the level of the synapse. (p. 68)

9. How does electroencephalograpy (EEG) detect brain activity?
a. EEGs measure electrical activity of the brain using sensors placed on the head. (p.70)

10. What are event related potentials, otherwise known as evoked potentials?
a. Evoked or event-related potentials are EEG tracings associated with a given event, such as recognizing a stimulus. (p. 71)

11. How does magnetoencephalography differ from electroencephalography?
a. MEG measures magnetic fields given off by the brain rather than electrical fields, and provides a more accurate spatial location for brain activity. (p. 72)

12. How is Positron Emission Tomography done, and what does it show?
a. PET scans involve giving people radioactive trace materials, then monitoring the radioactivity from the brain as the material is metabolized. This allows us to see what parts of the brain are active at any given time. (p. 73)

13. How are functional MRIs done, and what do they measure?
a. Functional MRIs take advantage of the fact that hemoglobin has different magnetic properties before and after oxygen is absorbed from it. People’s brain images are created while relaxing, and then that resting image is compared to brain images taken while the person is thinking. Changes in the image indicate where oxygen is being used most, and thus which brain part is most active. (p. 74)

14. What is Diffusion Tensor Imaging?
a. DTI is used in conjunction with an MRI. It allows us to see the clusters of axons, or white matter, that connects different parts of the brain together. (p. 75)

15. Which brain scan systems can detect changes in brain function over the shortest time span?
a. MEG and EEG can detect changes over the shortest timespan. (p. 77)

16. Researchers have examined three specific networks in studying psychopathology. What sort of brain activity is associated with the default or intrinsic network?
a. The default or intrinsic network is active when we’re not engaged in tasks and are letting our minds wander. (p. 79)

17. Problems with turning off the default network is associated with what prominent mental disorder?
a. Schizophrenics are among those who have trouble turning off the default network. (p. 79)

18. Researchers have examined three specific networks in studying psychopathology. What sort of brain activity is associated with the central executive network?
a. The central executive network is active when planning, setting goals, directing attention, performing, inhibiting some actions, and the encoding of working memory. (p. 79)

19. Researchers have examined three specific networks in studying psychopathology. What sort of brain activity is associated with the salience network?
a. The salience network appears to monitor the external world as well as our internal cognitive states for changes. (p. 78-80)

20. When researchers find that various parts of the brain become active together and also stop being active together, what do they tend to assume about those parts?
a. Becoming active and stopping becoming active together generally means brain parts are working together on whatever task the individual is engaged in when they become active. (p. 81)

21. There are two broad categories of neurotransmitters. What is the usual function of the small molecule neurotransmitters?
a. Small molecule neurotransmitters tend to be involved in rapid functions, that is, functions where neurons must fire rapidly at particular intervals. (p. 82)

22. There are two broad categories of neurotransmitters. What is the usual function of the large molecule neurotransmitters?
a. Large molecule neurotransmitters tend to be involved in slower, ongoing neural functions rather than those that must be signaled rapidly. (p. 82)

23. Besides the neurotransmitters that mediate communication between neurons, such as glutamate, and the ones that influence how that communication occurs, such as opiods, what other class of neurotransmitters are there?

a. The third class is the neurotransmitters that affect large groups of neurons, such as adrenaline (epinephrine), noradrenaline (norepinephrine), and serotonin. (p. 82)

24. About what proportion of human genes have varying alleles and thus allow humans to have differing traits?
a. About ¼ of human genes have varying alleles. (p. 84)

25. What does DNA tell your cells how to do?
a. DNA instructs the ribosomes in cells how to make proteins from amino acids. (p.85)

26. Researchers in genetics agree that the critical issue in how DNA works isn’t so much the genes themselves as what?
a. The critical, and still poorly understood issue, is how genes are turned on and off. (p. 85)

27. Genes themselves are not affected by environment in most cases, and thus are passed unchanged on to the next generation regardless of the environment of the parent. But factors that can influence how easily a gene is turned on and off can be affected by the parents’ environments. This form of environmental inheritance is known as what?
a. This process is called epigenesis. (p. 86)

28. To prevent DNA from access, it tends to be wrapped in clusters of protons. What are those clusters known as?
a. The clusters of proteins that wrap DNA and prevent it from being accessed are known as histones. (p. 86)

29. What do the epigenetic marks known as methyl groups do to DNA? What epigenetic marks reverse this process?
a. Methyl groups prevent DNA access. Acetyl groups unfurl DNA and allow access. (p. 87)

30. Rats whose mothers were less attentive and did less licking and grooming of their offspring were more likely to attach methyl groups to the DNA that controlled what response in those rats throughout their lives?
a. The rats whose mothers were less attentive made fewer receptors in the hippocampus that slows production of cortisol, a stress hormone. As the result, they were more susceptible to stress throughout life, even though their genes were unchanged. (p. 87)

31. Mitochondrial DNA is inherited from which parent?
a. Mitochondrial DNA is found in cell bodies, and thus is only inherited from mothers.

32. Humans appear to have carried genes related to schizophrenia for millennia. What are three possible evolutionary explanations from genes related to schizophrenia to linger in the human genome even though they appear to be harmful to human reproduction?
a. Like sickle-cell anemia, genes for schizophrenia may protect us from another, worse disorder. Secondly, perhaps genes for schizophrenia are normally functional, but their function breaks down under certain critical environmental conditions. Lastly, genes for schizophrenia may also cause some possible positive outcome as well, such as greater levels of creativity. (p. 90)

33. Name 3 biological or psychological conditions that have been found to have epigenetic components in humans.
a. Conditions verified to have epigenetic components include diabetes, cancer, obesity, addiction, and depression. (p. 88-89)

34. When we consider the effects of evolution on humans, we have to consider two ways humans are different from other animals. One is that humans exist largely in the context of their cultures rather than in the natural world. What’s the other way that humans are different from other animals that influences the effects of evolution?
a. The other major way that humans are different from other animals is that we have imagination and expectations, and thus we can live in a mental world very different from the actual physical one. (p. 89)

35. What is Neuroethics?
a. Neuroethics is the study of moral issues involved in neurological advancements, including advancements in genetic screening and brain scanning improvements. (p. 93)
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Module 3 self-study questions (and answers):
Chapter 4 questions:
1. What is the concept of falsification in the context of scientific investigation?
a. Falsification refers to the general scientific principle that scientific investigations should be designed to show that the current hypothesis is wrong. By looking for evidence that we’re wrong, we can be more sure that such evidence will be found if it exists. (p. 102)

2. What is one advantage and one disadvantage of doing case studies?
a. The major advantage of case studies is that they allow us to examine even very rare events in great detail. The major disadvantage is one of generalizability—we can’t really tell if the results of a case study are characteristic of other individuals or not. (p. 104-105)

3. How is a naturalistic observation done?
a. In conducting a naturalistic observation, investigators observe real world conditions while attempting to avoid disrupting or altering them as much as possible. (p. 105)

4. What is the difference between positive and negative correlations?
a. In a positive correlation, the two variables go together—as one variable increases in value, so does the other. In a negative correlation, the two go opposite directions—as one variable increase in value, the other decreases. (p. 106)

5. What range of values can correlations take? What correlational value would mean that two variables were not related to each other at all?
a. Correlations range from 1 to -1. A correlation of zero means that the two variables aren’t related at all. (p. 106-107)

6. Why can’t we make causal claims from correlational data?
a. Although causal events are generally correlated, a correlation between events does not imply causation. Instead of variable A causing B, it’s possible variable B causes A (the directionality problem). It’s also possible that a third variable causes both other variables (the third variable problem). (p. 108)

7. What do psychologists mean by the term “operational definition?”
a. An operational definition is a precise definition or concrete meaning of a term. (p. 109)

8. Distinguish between the independent variable and the dependent variable in an experiment.
a. The independent variable is the one that’s manipulated in an experiment, whereas the dependent variable is the one that we observe to see if it’s affected by the independent variable. (p. 109)

9. What is meant by the term “confounding variable?”
a. A confounding variable is any variable other than the independent variable that affects the dependent variable in an experiment. (p. 109)

10. Differentiate between internal and external validity.
a. Internal validity refers to whether the experiment was designed to control for and rule out alternative explanations for a given result. External validity refers to whether the results of the experiment can be generalized to real-life situations. (p. 112)

11. What do scientists mean by the term “demand characteristics?”
a. Demand characteristics are situations that influence a participant’s response quite separately from the independent variable, such as when children act hyperactive when they consume sugar because they think they’re supposed to. (p. 113)

12. What is a double-blind experiment?
a. A double-blind experiment is an experiment where neither the participants in the experiment nor those collecting the data know which participant is in which experimental group. (p. 113)

13. What is meant by the term, “match subjects design?”
a. In a match subjects design, researchers try to match up people in the observation group of an observational study with people in a control group on as many possibly relevant variables as possible. (p. 114)

14. Why do scientists use inferential statistics in studies?
a. Inferential statistics allow scientists to determine if a particular outcome is different from what might occur merely by chance. (p. 117)

15. How does one do a longitudinal study?
a. When experimenters do a longitudinal study, they follow a specific individual or group across time, recording changes in behavior occurring over that time. (p. 122-123)

16. How does lifetime prevalence of a condition differ from overall prevalence?
a. Lifetime prevalence refers to the proportion of the population will have a given condition at some point in the lifetime. Overall prevalence refers to the proportion of the population will have a given condition at a particular time. Lifetime prevalence is always much larger than overall prevalence. (p. 124)

17. Distinguish gene by environment interactions with gene by environment correlations.
a. Gene by environment interactions refer to differing responses to the environment that may be shown by people with different genetic endowments. Gene by environment correlations refer to the likelihood that certain genes and certain environments may occur together. (p. 126)

18. If identical twins are more similar than fraternal twins on a given trait, and identical twins reared apart are almost as similar on that trait as identical twins reared together, what would that tell us about the relative contribution of genetics to the appearance of the trait?
a. If identical twins are more similar than fraternal twins on a given trait, and identical twins reared apart are almost as similar on that trait as identical twins reared together, it’s likely that genetics plays a very large role in appearance of the trait. (p. 127)

19. What is the difference between an outcome being statistically significant and that outcome being clinically significant?
a. A statistical analysis may show that one treatment is significantly different from another in that the resulting difference would not be likely to occur by chance. But a clinically significant difference refers to whether that difference is enough to matter to the participants. A statistically significant result may or may not be clinically significant. (p. 127)

20. What is a meta-analysis?
a. Meta-analysis is a technique for combining the results of multiple studies and looking for statistical significance within the whole set of studies. (p. 128)

21. What basic idea is at the heart of ethical considerations in psychological studies?
a. The first rule of psychological studies of human beings is that the people in the study should not experience harm as a result of being in the study. (p. 128)

22. Another important principle of human research is that the participant in a study should be made completely aware of what they will experience in the study, so they can decide on their own whether to participate or not. What is this principle known as?
a. This is the principle of informed consent. (p. 130)
Chapter 5 questions
1. What is the name of the current American Psychiatric Association Manual for the diagnosis of mental illnesses?
a. The current APA manual for the diagnosis of mental illnesses is the Diagnostic and Statistical Manual of Mental Disorders, Version 5, otherwise known as the DSM-5. (p. 140)

2. What is the SCID?
a. The SCID is the Structured Clinical Interview for DSM Disorders. (pp. 141-142)

3. What does the DSM-5 use to assess cultural dimensions of people’s behaviors during diagnosis?
a. The DSM-5 uses the Cultural Formulation Interview (CFI) to put information about a patient’s behavior in a cultural context. (pp. 142-143)

4. Distinguish between inter-rater reliability and test-retest reliability.
a. Inter-rater reliability refers to whether we get the same results when the same person or group is assessed by different people. Test-retest reliability refers to whether we get the same results when the same person or groups is assessed at different times. (p. 144)

5. What do psychologists mean when they talk about a test’s validity?
a. Validity refers to whether the test measures what it purports to measure. (pp. 144-145)

6. What is meant by an assessment’s ecological validity?
a. Ecological validity refers to whether the assessment relates to the real world, especially to a wide range of cultural situations. (p. 145)

7. What kind of an assessment is the Beck Depression Inventory?
a. The Beck Depression Inventory is a symptom questionnaire. (pp. 145-146)

8. How does the Minnesota Multiphasic Personality Inventory assess mental symptoms as well as personality?
a. The MMPI and MMPI-2 consist of a large number of questions that were chosen because people in clinical populations answer the questions differently from normal people. If a person answers in the same way as a people with known personalities or known mental illnesses answer, he or she probably has a similar personality or mental illness. (pp. 146-147)

9. What kind of questions are on the validity scale of the MMPI that’s known as the Lying scale?
a. The Lying scale has questions that people who are healthy have to admit to even though the question makes them look a bit negative. People who are lying to look good will answer those questions in such a way as to look positive, and if they answer enough of them that way they’re almost certainly lying. (pp. 147-148)

10. How does the Rorschach test assess personality and mental illness?
a. The Rorschach is a projective test involving a selection of inkblots. Patients say what the blots remind them of and why they think that. The blots are scored according to the Exner scoring system or the R-PAS scoring system, both of which contain norms for the answers of people with different mental illnesses and personalities. (pp. 148-150)

11. How does the TAT assess personality and mental illness?
a. The TAT consists of a group of 30 black and white drawings with ambiguous content. The person tells a story about each card, and then the content of the stories is analyzed for central themes. (p. 150)

12. The DSM-5 is used for classifying mental illnesses in North America. What classification system is used in Europe?
a. Europeans use the International Classification of Diseases (ICD), published by the World Health Organization. (p. 154)

13. One of the big changes in the DSM-5 is the use of dimensional assessment, coupled with introduction of spectrum disorders. What does this mean?
a. The DSM-5 considers the severity of symptoms for the first time, not just their presence. So disorders can be listed in terms of magnitude, with some disorders being listed on a spectrum from milder to more severe disorders. (p. 157)


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Module 4 self-study questions (and answers):
1. What part of the brain develops first in infants, and what section of the brain is the last to develop, not finishing until early adulthood?
a. The visual and motor centers develop first in infants. The final section to develop is the frontal lobes. (p. 166)

2. What two sections of the limbic system have been found to be smaller in people who experience extreme stress as children?
a. The hippocampus and amygdala both are smaller in people who experience extreme stress as children. (p. 166)

3. John Bowlby suggested that lack of ______ was associated with a wide variety of psychological disorders?
a. Bowlby argued that lack of attachment was associated with a wide variety of psychological disorders. (p. 166)

4. Studies with Rhesus monkeys that were conducted by Harry Harlow found that attachment was driven by what process, rather than the feeding process as was previously thought?
a. Harlow discovered attachment was associated with contact comfort, and not the feeding process. (p. 167)

5. What attachment patterns did Mary Ainsworth find in infants, and what attachment pattern did other researchers suggest should be added to that list?
a. Ainsworth found most children showed the secure attachment pattern. She also found children showed the avoidant attachment pattern and the anxious/ambivalent attachment pattern. Later researchers added the disorganized/controlling attachment pattern. (pp. 168-169)

6. What kind of parenting do we often find in parents of children with anxious/ambivalent attachment patterns? What kind of parenting do we often find in parents of children with disorganized/controlling attachment patterns?
a. Children who are anxious/ambivalent tend to have parents who are inconsistent in child care and intrusive. Those with disorganized/controlling attachment tend to have parents who are unpredictably abusive or frightening to the children. (p. 169)

7. What are mirror neurons, and what purpose to they serve?
a. Mirror neurons are neurons that fire both when motor actions are engaged, and when motor actions of others are observed. Thus, mirror neurons turn observed behaviors into a personal motor action plan. (p. 170)

8. What disorder to mirror neurons appear to be involved in?
a. Mirror neuron problems seem to be important in autism spectrum disorders. (p. 170)

9. According to false-belief tasks, children start being able to understand what other people see and know at about what age?
a. Children appear to start being able to understand what other people see and know at about the age of 4. (p. 171)

10. Baron-Cohen argues there are 4 components to children’s developing ability to infer mental states in another person. The first is the intentionality detector. What are the other 3?
a. In addition to the intentionality detector, the other three components of the theory of mind are the eye direction detector, the shared attentional mechanism, and the theory of mind mechanism. (p. 171)

11. What are some of the mental disorders that generally are not seen until adolescence?
a. Panic disorder, generalized anxiety disorder, post-traumatic stress disorder, substance abuse, mood disorder, and schizophrenia generally don’t appear until adolescence. (p. 172)

12. How is risk-taking in adolescence affected by the presence of peers, and how does that change in adulthood?
a. Adolescents do more risk taking when peers are present than on their own, whereas young adults do not. (pp. 173-174)

13. According to your text, there are three processes that involve brain structures associated with social interactions. What are those three processes, and what parts of the brain do they use?
a. First, higher-level regions in the cortex must process the sensory information of the social interaction. Second, the affective system (including the amygdala) must process the emotional significance of the event. Third, the higher-level regions of the cortex have to create a mental model of the social world, figuring out what mental states the other person is feeling, and determining what effect our actions would have on them. (p. 175)

14. What section of the brain appears to be involved in the process of learning what affect is associated with what we know about specific outcomes of behaviors, and thus is involved in learning fears, emotional regulation, storing and retrieving episodic and semantic memories, and understanding the feelings and emotions of others?
a. The section of the brain controlling all these important functions is the ventromedial prefrontal cortex. (p. 176)

15. How do children behave who have reactive attachment disorder?
a. Children with reactive attachment disorder generally do not show emotional responsiveness or positive affect in social interactions. They also were not cared for as children. (p. 177)

16. How do children with disinhibited social engagement disorder behave?
a. Children with disinhibited social engagement disorder are indiscriminant in their social behavior—they’ll readily act familiarly with strangers. They also were not cared for as children, but that lack of care appears to need to begin before age 2. (pp. 177-178)

17. Children who suffer from autism spectrum disorders have difficulty in what three areas?
a. Those with autism spectrum disorders have trouble connecting to others socially, they have trouble with language and communication, and they have behavioral problems including the desire to do the same behaviors over and over again. (p. 178)

18. Where does Asperger’s syndrome now fit into the DSM-5?
a. Asperger’s syndrome is considered as part of the more functional end of the autism spectrum in the DSM-5. People with Asperger’s are seen as more functional autistics. (p. 178-179)

19. How do children with autism spectrum disorders do on traditional IQ tests, and how does that compare to their performance on the Raven Progressive Matrices test?
a. Children with autism spectrum disorders tend to do poorly on IQ tests that include verbal content, but they often score higher on the nonverbal Raven Progressive Matrices test. (p. 180)

20. What is the status of the claim, widely present on the Internet, that autism is caused by vaccinations?
a. The claim that autism is caused by vaccinations has been completely debunked—children who are vaccinated have no higher rates of autism than those who are not. ( p. 182)

21. How is autism related to the age of the parent?
a. Autism goes up dramatically with the age of the mother, with youngest mothers having the lowest rate of autism in their children, and older mothers the highest. Autism rates are also higher in children of men over 50. (p. 182)

22. What does the empathizing-systemizing theory of autism suggest about the thinking of autistics?
a. The empathizing-systemizing theory of autism suggests that autistics are much less good than normal people at empathizing or reading the emotions of others. But they’re much better at systematizing, or organizing things into groups and understanding the rules that govern them. (p. 183)

23. What odd brain growth pattern do children with autism show when they’re between the 2nd and 4th year of life?
a. The overall brain volume of autistics increased between the 2nd and 4th year of life, a phenomenon not found in normal children. (p. 183)

24. How common are autism spectrum disorders, and what sex differences are there in incidence of autism spectrum disorders?
a. About 1 in 100 children have some form of autism spectrum disorder, with the number of boys to girls ranging in studies from 2 to 1 through 5 to 1. (p. 184)

25. How common are special abilities or talents among those with autism spectrum disorder?
a. Somewhere around 10% of people with autism spectrum disorder have special talents or abilities that involve rote memory. (p. 186).

26. What are the major steps of the UCLA Young Autism Project developed by Lovaas?
a. The first step in the UCLA Young Autism Project is to establish a teaching relationship with the child. Then children are taught foundational skills. After that, focus in on beginning communication. In the fourth stage, the basic processes of language are stressed. In the final stage, communication in order to function in school and peer interactions is stressed. (p. 187)

27. What are the two major dimensions of attention deficit hyperactivity disorder?
a. The two dimensions are inattention and hyperactivity and impulsivity. (p. 187)

28. What are two of the three disorders that are often comorbid with ADHD?
a. ADHD is often comorbid with oppositional defiant disorder, anxiety disorders, and conduct disorder. (p. 190)

29. How heritable is ADHD, according to heritability studies?
a. ADHD is roughly 76% inherited. (p. 190)

30. What class of drugs are generally given to people with ADHD?
a. Children with ADHD are generally treated with stimulants such as methylphenidate (Ritalin) or dextroamphetamine (Adderall). (p. 191)

31. For many years, it was argued that childhood onset conduct disorder was more biological in nature than adolescent onset conduct disorder. Why is this no longer believed to be the case?
a. Brain scans of people with adolescent onset conduct disorder have found that they show abnormal activation of the amygdala and reduced amygdala volume, just as those with childhood onset conduct disorder. (p 192)

32. How are the symptoms of oppositional defiant disorder different from those of conduct disorder?
a. Children with ODD are angry and defiant to authority, but do not behave aggressively toward other people and animals, nor do they tend to randomly destroy property. (p. 193)

33. What is the difference between the diagnosis of learning disabilities and the diagnosis of intellectual development disorder?
a. Learning disabilities are specific, and involve the child’s achievement hovering at levels lower than would be expected from their scores on achievement or intelligence tests in one or more areas. Intellectual developmental disorder involves children whose achievement and test scores are both low, and who tend to show global deficits rather than specific ones. (p. 195)

34. According to the text, what are the three different categories of biological disorders that underlie intellectual developmental disorder?
a. The three underlying biological disorders of intellectual development disorder are chromosomal disorders, metabolism disorders, and disorders related to gestation. (pp. 196-198)

35. What are three of the many factors that may cause fetal damage during gestation, leading to intellectual development disorder?
a. Included in this list are exposure to alcohol and cocaine; deficiencies in iron, zinc, and iodine; and exposure to a wide variety of infections. (p. 197-198)

36. What are the two critical periods in development where the brain is more sensitive to both outside and inside factors?
a. The two critical periods are during gestation and infancy, when connections to the cortex are being organized initially, and during adolescence, when a major brain reorganization takes place. (p. 165)

37. The major categories of Childhood Disorders on the DSM-5 include trauma- and stressor-related disorders and what other two groups?
a. The other two groups are (1) neurodevelopmental disorders and (2) disruptive, impulse control, and conduct disorders. (pp. 164-165)
___

Module 5 self-study questions (and answers):
1. What is the relationship between the terms “schizophrenia” and “psychotic disorders?”
a. Psychotic disorders are a broad category of disorders that involve people being out of touch with reality and possessing abnormal thinking and sensory processes. Schizophrenia is one of many psychotic disorders. (p. 207)

2. What is meant by positive and negative symptoms of schizophrenia?
a. Positive symptoms of schizophrenia are symptoms that schizophrenics have and that aren’t found in normal people, such as auditory hallucinations. Negative symptoms of schizophrenia are behaviors that normal people show but that are absent in schizophrenia. (p. 208-210)

3. What are the most common positive symptoms of schizophrenia?
a. The most common positive symptoms of schizophrenia include auditory hallucinations, delusions of persecution, delusions of grandeur, and delusions of control. (p. 209)

4. What are the most common negative symptoms of schizophrenia?
a. The most common negative symptoms of schizophrenia include avolition, alogia, and anhedonia. (p. 210)

5. What are the four phases of the natural course of schizophrenia?
a. The four phases are the premorbid phase, the prodromal phase, the psychotic phase, and the stable phase. (p. 211)

6. What did Kraepelin mean by the term “dementia praecox?”
a. Dementia praecox was used by Kraepelin to refer to schizophrenia. It literally means “premature dementia.” (p. 212)

7. The DSM-IV referred to five subtypes of schizophrenia, but the DSM-V has discarded this classification system. What were the DSM-IV subtypes of schizophrenia?
a. The five subtypes are paranoid, disorganized, catatonic, undifferentiated, and residual. (p. 213)

8. Some people have argued that schizophrenia exists in the population throughout the world because it is associated with another, much more positive trait that increases survival chances. What positive trait is schizophrenia believed to be associated with?
a. The positive trait associated with schizophrenia is creativity. (p. 216)

9. What brain differences are found in people who developed schizophrenia prior to puberty compared to those who developed it later?
a. Children who developed it prior to puberty showed larger ventricles in the brain as well as greater loss of gray matter. (p. 218)

10. What differences were found in the DNA of people with schizophrenia compared to healthy individuals?
a. The DNA of people with schizophrenia shows more deletions and duplications of base sequences compared to healthy individuals. (p. 220)

11. What kinds of neuromotor abnormalities of the eyes are found in schizophrenics and the relatives of schizophrenics compared to normal people?
a. Neuromotor abnormalities include eye movement abnormalities, where schizophrenics follow smooth movements of objects with periods of quick jerky movements where they appear to be catching up with the object. (p. 221)

12. What are brain ventricles, and how do the ventricles of schizophrenics compare to those of normal people?
a. Ventricles are spaces in the brain filled with cerebrospinal fluid, and they tend to be larger in schizophrenics. (p. 222)

13. Schizophrenic symptoms are associated with abnormal activity in what lobe of the brain?
a. Schizophrenic symptoms are associated with abnormal activity in the prefrontal lobes. (p. 223)

14. What type of brain tissue appears to be seriously reduced in patients with schizophrenia?
a. Schizophrenics show dramatic reduction in gray matter levels, especially in the hippocampus, the temporal lobes, the frontal lobes, and the parietal lobes. (pp. 225-226)

15. How does the amount of white matter in the brain differ between normal individuals, those experiencing their first schizophrenic episodes, and those with chronic schizophrenia?
a. Those experiencing their first schizophrenic episodes show no significant difference in white matter levels, but chronic schizophrenics show reduced levels of white matter in the brain. (p. 228)

16. What happens to the default network of the brain when normal people are engaged in tasks, and how do schizophrenics and relatives of schizophrenics differ in that area?
a. In normal individuals, the default network is suppressed during cognitive tasks. In schizophrenics and relatives of schizophrenics, suppression of the default network is much reduced when engaged in cognitive tasks. (p. 229)

17. The auditory hallucinations found in schizophrenics appear to arise from problems with transferring information from the left inferior frontal gyrus to what section of the brain involved in language understanding?
a. Auditory hallucinations appear to involve problems transferring information from the left inferior frontal gyrus to Wernicke’s area. (p. 229)

18. What evidence supports the idea that dopamine overactivity may be involved in the appearance of schizophrenic symptoms?
a. Evidence of the involvement of dopamine in schizophrenia includes the fact that most drugs that ease schizophrenic symptoms reduce dopamine activity, the fact that stress raises dopamine levels and also triggers schizophrenic outbreaks, the fact that creativity is related to dopamine production, and that amphetamines cause schizophrenic symptoms and also raise dopamine levels. (p. 230)

19. What role does glutamate play in schizophrenia?
a. When glutamate receptors are blocked in normal people, they show schizophrenic-like symptoms, suggesting glutamate levels play a role in psychosis. (p. 230)

20. How do results using the Charlie Chaplin illusion provide evidence that schizophrenia involves problems with top-down processing?
a. People with schizophrenia don’t see the Charlie Chaplin illusion (viewing the back side of a mask as a forward facing face) when the back side of the mask is presented, but normal people do. This suggests that they have trouble imposing a sensory expectation on a stimulus, which is a top-down processing skill. (pp. 231-232)

21. What sex differences are there in age of onset of schizophrenia?
a. Males generally show earlier onset of schizophrenia than females. (p. 233)

22. When do the psychotic symptoms of schizophrenia usually first appear?
a. Most people show their first psychotic symptoms in adolescence or early adulthood. (p. 233)

23. What is the relationship between schizophrenia and substance abuse and cigarette smoking?
a. Schizophrenics are more likely to be smokers and to be substance abusers. (p. 233)

24. What patient factors predict poorer outcomes in schizophrenic patients?
a. Outcomes are poorer for males, those who develop symptoms very early, those who go long periods of time before treatment, those who have many cognitive symptoms, and those who have many negative symptoms rather than positive symptoms. ( p. 233)

25. Locking schizophrenics up in mental hospitals has sharply diminished since the 1960s, and now most schizophrenics are treated as outpatients. What notorious problem has arisen instead?
a. As a result of the cessation of treatment of schizophrenics in mental hospitals, a large number have become homeless individuals living on the streets. (p. 234)

26. People with schizophrenia respond best to chlorpromazine when they show what class of schizophrenic symptoms ?
a. Chlorpromazine works best on those with positive symptoms of schizophrenia, and doesn’t appear to help those with negative symptoms at all. (p. 235)

27. What is tardive dyskinesia?
a. Tardive dyskinesia is a disorder that people taking first generation antipsychotics sometimes develop, involving involuntary movements, especially tongue and lip movements. (p. 235)

28. What is the major advantage of second generation antipsychotics?
a. Second generation psychotics seem to work just as well on positive symptoms as first generation antipsychotics, and work better on negative symptoms. (p. 235)

29. How do the individual’s own cognitive assessments affect things like school and work performance of schizophrenics?
a. Schizophrenics will engage in maladaptive cognitive appraisals of their work or school performance such as “I’m not as good as other people,” which then leads to nonfunctional behavior such as social withdrawal or reduction of task effort. (p. 236)

30. What is a therapeutic alliance?
a. A therapeutic alliance is a strong, trusting relationship between therapist and client. It’s important to establish a therapeutic alliance at the onset of therapy. (p. 237)


___
Module 6 self-study questions (and answers):
1. What term did Ancient Greeks like Hippocrates and Galen use to refer to depression?
a. Hippocrates and Galen referred to depression as melancholia. (p. 245)

2. Major depressive disorder is often comorbid with what other disorders?
a. Major depressive disorder is often found to be comorbid with anxiety disorder, obsessive-compulsive disorder, and substance abuse. (p. 245)

3. What hormone is released in response to stress?
a. Stress promotes release of cortisol (a glucocorticoid). (p. 249)

4. How does the prevalence of depression in females differ from the prevalence in males?
a. Females suffer from depression at twice the rates males do. (p. 250)

5. How do the symptoms of depression in children differ from the symptoms for depression in adolescents and adults?
a. Children are more likely to describe depression in terms of headache, stomach ache, and other physical symptoms. (p. 250)

6. What does the cognitive model of depression suggest is the cause of depression?
a. The cognitive model argues that depression is due to a bias toward focusing on negative rather than positive events from the past as well as viewing past events more negatively in general. (p. 251)

7. What is the negative cognitive triad in relation to depression?
a. The negative cognitive triad involves negative schemas concerning the self, the personal world, and the future. (p. 251)

8. How does activity in the anterior cingulate cortex of normal individuals differ from that of depressed individuals when asked not to focus on positive information and when asked not to focus on negative information?
a. Normal individuals show activity in the anterior cingulate cortex when asked to focus on negative information but not when asked to focus on positive information. Depressed individuals show more activity when asked not to focus on negative information. (p. 251)

9. How does the macrophage theory of depression explain the loss of interest in interacting with others and general malaise that is found in depression?
a. The macrophage theory of depression argues that a malfunction of the immune system results in the release of cytokines, the chemical signals from the immune system that are produced when infections occur. (p. 252)
10. What psychological condition is found more often prior to puberty in individuals who develop major depressive disorder after puberty?
a. People who develop major depressive disorder after puberty show signs of elevated anxiety disorders prior to puberty. (p. 253)

11. What is the relationship between cortical thickness and the symptoms of major depressive disorder?
a. The less the cortical thickness in the brain, the greater the symptoms of major depressive disorder. (p. 253)

12. What do theories of resource conservation see as the evolutionary advantage of the presence of depression responses in the human genome?
a. Theories of resource conservation argue that by ceasing activity and conserving energy in situations where we have failed, we save that energy for the next situation, where we might have greater chances of success. (p. 255)

13. What do theories of social competition see as the evolutionary advantage of the presence of depression responses in the human genome?
a. Theories of social competition argue that depression is part of a de-escalation strategy by the losing individual of a social competition, allowing him or her to escape the competition situation intact and without further harm. (p. 255)

14. What does the social risk hypothesis see as the evolutionary advantage of the presence of depression responses in the human genome?
a. The social risk hypothesis argues that depression reactions in interpersonal relationships limit the amount of social humiliation the person will face by encouraging withdrawal and signs of social submission such as cessation of eye contact and lowered voice tone. (p. 255)

15. How does cognitive behavioral treatment of depression compare to antidepressant medications in effectiveness over the short term and over the long term?
a. Both are about equally effective over the short term. Over the long term, CBT is a more effective therapy, with lower relapse rates. (p. 256)

16. Antidepressant medications appear to decrease hyperactivity in the amygdala directly. What does cognitive therapy appear to do to brain functioning?
a. Cognitive therapy appears to increase prefrontal cortex functioning, which in turn appears to decrease amygdala reactivity. (p. 257)

17. What are the four classes of drugs that are used to treat depression?
a. The four classes of drugs used to treat depression are Tricyclics, MAO inhibitors, Selective Serotonin Reuptake Inhibitors (SSRIs), and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) (pp. 257-258)

18. What are some of the common side effects of drugs used to treat depression?
a. Drugs used to treat depression can cause weight gain, sleep problems, loss of interest in sexual activity, and increased thoughts of suicide. (pp. 257-258)

19. What is the current theory of how ECT decreases depressive symptoms?
a. Currently, it is believed that ECT decreases depressive symptoms by reducing the connectivity between the frontal lobes and the limbic system. (pp. 258-259)

20. Vagal Nerve Stimulation, which has been shown to decrease depression in some individuals, was originally developed to treat what other condition?
a. Vagal Nerve Stimulation was developed to treat epilepsy. (p. 259)

21. The very recent treatment for depression that involves generating multiple pulses of magnetic fields above the Dorsolateral Prefrontal Cortext (DLPFC) is known as what?
a. This is known as Transcranial Magnetic Stimulation. (p. 259)

22. To what do Cognitive Therapists such as Aaron Beck attribute depression?
a. Beck attributes depression to dysfunctional and negative thoughts. (p. 260)

23. Describe the major sex differences in suicide attempts and suicide deaths.
a. Females attempt suicide more often than males, but males actually kill themselves more often than females, primarily because males use the more deadly means more often. (pp. 276-277)

24. How does emotion focused therapy for depression differ from cognitive therapy for depression?
a. Emotion focused therapy requires the participants to relive the emotions associated with past experiences in a safe environment with therapist assistance, so that the person can learn new, more moderate responses. (p. 262)

25. How does bipolar II disorder differ from bipolar I disorder?
a. Bipolar II disorder victims have significant bouts of major depressive disorder interspersed with mania, something not required for Bipolar I. Also, they experience hypomania rather than manic episodes, which means their symptoms are less vivid and shorter-lived. (p. 265)

26. What do we call the much milder bipolar disorder where people have mood changes that aren’t nearly as severe as those in Bipolar I and Bipolar II?
a. This is known a Cyclothymic Disorder. (p. 269)

27. Name two famous individuals who probably suffered from some form of bipolar disorder?
a. Among the most famous people to suffer bipolar disorder were Theodore Roosevelt, Jackson Pollack, Peter Wentz, Winston Churchill, Ernest Hemingway, Virginia Woolf, Sergei Rachmaninoff, Peter Tchaikovsky, Sylvia Plath, and Mark Rothko. (p. 271, Module 6 videos).

28. What simple salt is a common treatment for bipolar disorder?
a. Bipolar disorder is often treated with lithium carbonate. (p. 274)

29. In contrast to the rest of the world, how do suicide rates in the United States compare?
a. The United States is in the middle of the pack in suicide rates, which are much higher in some countries and much lower in others. (p. 276)

30. What two personality traits are associated with suicidal ideation?
a. Suicidal ideation is associated with aggression and with impulsivity. (p. 277)

How much of this should we ignore? Like all of it, or was I just not supposed to click on the thread and I've already failed?

I only ignored some of it.
I might not have ignored any of it, but then I got tired of not ignoring it, so I stopped.

tl;dr

Dissociative Identity Disorder
Module 8, Video 1
Slide 2: Dissociative Identity Disorder
Now, if you want an example of how psychological views of a disorder might change over time to where the disorder almost becomes unrecognizable compared to the original one, you can't do any finer than with what was originally called multiple personality disorder. Multiple Personality Disorder is one of those things that media just loves as the plots of books, as the plots of movies, as the plots of television shows. People love the idea of a person who has multiple identities inside of the same body, and assumes different identities at different times. There have been a number of movies that have used this as a plot device. For example, “The Three Faces of Eve,” or the movie “Sybil” involve characters in which people have different personalities, and they're very different people at different times. Now, if you go back to earlier versions of the DSM, what is now called the Dissociative Identity Disorder, used to be very narrowly defined. They talked about people who had distinctively different personalities that were inside of the same body. They would move from one personality to another without their conscious control. Those personalities, they assumed fully when they had them. Some of the personalities were not aware of the other personalities. It's the kind of thing that's very colorful. It's the kind of thing that gets a lot of people's imaginations going. So of course, it's a great basis for a plot device in a story or in a movie. The thing is there was great debate entirely over just how common this was. At that time, we said, " Well, it was the single rarest of disorders.” That if you look in terms of people whose walk and talk, and handwriting, and names and entire set of memories changed when they change personalities, there were only a handful of such cases that have been documented over the years at least with any kind of detail. It's seemed like an incredibly rare disorder.

Slide 3: Dissociative Identity Disorder
Then more recently in the DSM V, there's been this shift in the description of Dissociative Identity Disorder. As was the case with Autism Spectrum Disorder, where they said, " Instead of talking about one disorder, let's talk about a range of disorders from milder to more severe." They started doing the same thing with Dissociative Identity Disorder where they said, " Okay, you have these very rare conditions where people abruptly become another personality, and all of their mannerisms and their memories, and their handwriting, and the way the walk all changes." You have that one group of people where those qualities all change, and they seem like distinctively different people. They're very rare, not many cases like that at all. Then you have a continuum down from there, from those people who absolutely become very different personalities to those people whose personalities change dramatically but they're not necessarily such different personalities. Then ranging down from there to those people who just don't have one set personality, but rather have personalities that shift around all the time. Well, if you have a continuum of diagnosis for Dissociative Identity Disorder, and let it range on down to the people who have very changeable personalities which aren't set in one place all the time, well then the number of people who have this disorder becomes much, much larger because you're including in the diagnosis people who didn't used to be included in the diagnosis. We've gone from a disorder that you hardly ever see, and that nobody much has been diagnosed with. We've shifted that disorder's criteria to say, " You can have lesser symptoms, and still be classified with that disorder," and because of this, now they're classifying way more people with Dissociative Identity Disorder, people who are fringing on what we'd have called Dissociative Identity Disorder before how are now classified as having Dissociative Identity Disorder. It's a case of changing the way the diagnosis is done, which includes a lot more people.


Obesity in America, Part 1: Little Exercise, Lots of Food
Module 8, Video 2
Slide 2: Lack of Exercise
One of the things you might have garnered from reading this chapter is that Americans are very heavy people, we are among the heaviest people in the world. We weren't always that heavy, as the charts in your textbook point out. Americans were thinner just a few decades ago than we are now, but we are gradually getting heavier and heavier. Every new decade seems to be the heaviest Americans ever. You get into this whole issue of why is that? Why are we gradually growing fatter and fatter? It's a good question. Now, there are a number of possibilities behind Americans growing fatter. We could for example point out the fact that manual labor jobs are very scarce these days. Most people don't do back breaking labor all the time. Certainly then you are getting a lot of exercise at work. It's true that we've had fewer and fewer jobs where people get exercise at work over the last few decades. Not having manual labor might be contributing to the job, not working all the time. It's also possible that our changes in leisure time activities have had an effect on our general level of obesity. The preferred leisure time activities of Americans today often involve doing a lot of sitting down. We have cable TV networks and satellite TV networks with 500 channels, and Netflix and Hulu to send us things, to sit and watch on TV. We have video games galore to play. In addition to that, there are social media and the internet to explore. That means a lot of time, in leisure time, just sitting and not exercising. Whereas in the past Americans did more exercising in leisure time. Americans did more outside activities, they played more outside games, and just generally got more exercise than they do today.

Slide 3: Larger Meals
Neither of those things can be totally responsible for why Americans are among the fattest people on Earth, because that's true of many other countries too. Many other countries also don't do much manual labor. Many other countries also have internet and many TV channels and video games to play. Why is it that Americans are so heavy? Putting aside our activity levels you might then turn to what kind of food do we consume, and how much food we consume? There we are probably getting closer to the roots of the whole problem. Americans seems to eat more food than many other people do. We seem to eat larger meals and we seem to eat more between meals than many other people do. That chart in your textbook is a real eye opener showing how Americans consume more than 3,000 calories a day whereas the residents of many other countries consume far fewer calories a day. We are eating larger meals, larger portions in our meals and just taking in more calories during the day.

Slide 4: Big Portions
The food portions issue comes into play when you consider that a lot of restaurants for example have discovered that you will make more money if you sell larger portions, charge more for those larger portions and then you are getting more money out of each customer in the same amount of time. A customer doesn't feel cheated because the portions are so large they can stuff themselves, they still have food to take home. At the same time the restaurant is making more money with each sitting of diners because they are getting more money for each meal out of the diners. When you have more food in front of you, you tend to eat more food. Studies have indicated that if we put larger portions in front of people and say to people “eat what you want,” the larger portion we put in front of the person the more food they'll tend to eat overall. It's possible just by scaling up our portions we have contributed to people eating more in a given setting.

Slide 5: Proximity to Food
Of course we don't just eat during meals, there is also eating between meals. Americans probably do more snacking between meals than a lot of other people do. We have fast food restaurants all over the place. In addition to fast food restaurants we have little corner markets into which you can go in and buy all sorts of snacks and drinks and things to take out in the middle of the day. So that you have constantly got this proximity of food, tempting people to come in and grab something fun to eat. Come in and get something good to eat. Offering us all sorts of tempting treats, all sorts of tempting drinks, and those things drunk throughout the day would add up to quite a few calories.

Obesity in America, Part 2: Soft Drinks, Profits, and Corn Syrup
Module 8, Video 3
Slide 2: Soft Drinks
But my favorite villain in American obesity, the one that I think is more responsible than any one single factor is soft drinks. Most specifically soda or pop depending on which coast you live on. You'll call it one or the other. Soft drinks originally came about, the soft drink industry really got started with medicinal tonics that were made up in drugstores and given to people in order to cure them of malaise or tiredness or stomach problems. Coca Cola, for example, was originally a medicinal preparation that contained cocaine to pep people up. You'd go to your druggist. They'd take a little syrup of Coca Cola. They'd mix it with some carbonated water, and you would drink it, and it was supposed to pep you up, which undoubtedly I imagine it did, even though it only had minuscule amounts of cocaine in it. When in the late 1800's it became obvious that having cocaine was probably not the best thing, Coca Cola dropped the cocaine and replaced it with equivalent amounts of caffeine. But it was still considered a medicinal drink for some time, and Pepsi Cola, Dr. Pepper, both of those were stomach tonics that were supposed to excite your digestive system and get it to working better and less sluggishly. The word “pep” in both of those refers not to making people more peppy but rather to the word pepsin, referring to its supposed effects on your stomach. These drinks were originally medicinal drinks, and druggists could sell them for medicinal drinks, but they were also tasty and people would sometimes buy them to enjoy the taste. But eventually they got into bottling these drinks and selling them already prepared in bottles. Bottled sodas is something you might want to take along on a picnic, that you might want to indulge in now and then, became advertised more and more frequently and became a bigger part of the American diet. As we got into the 50's and 60's, bottlers were really pushing the idea of drinking soda as opposed to other things. But even then, soda wasn't consumed that heavily. You had to carry bottles around and you had to return the bottles afterward, and it was all kind of a hassle. What really brought soda into its own was the fast food industry.

Slide 3: Profits
You see, there's not a huge profit in bottling soda and transporting it to places and selling it. Oh, there's certainly a profit there. There's no question about that. But it costs money to transport things in glass across the country. The water that the soda itself is made out of is quite heavy, too. The shipping gets to be pretty expensive. On the other hand, it's a whole lot cheaper to ship the syrup that you make the soda from and then mix that syrup with water and carbon dioxide on the spot, and create fountain drinks, and fountain drinks dispensers became more and more common in part with the advent of fast food restaurants. Fast food restaurants were one place were you'd be distributing a whole lot of soda over a short period of time, making it right there on the spot, very economical and a really good way for fast food restaurants to pad their bottom line. When original fast food restaurants, places like McDonald's and Henry's and other hamburger joints like that first came into being, what they tended to serve was burgers and fries and shakes, and those were the big sellers at the time. But the trouble with those particular things is the mark up on them is not terrific. You have to sell a lot of burgers and fries and shakes to make a whole lot of money out of a fast food restaurant 'cause you're not making that much for each item you sell. Now, carbonated drinks are another matter. You can buy the fountain syrup very cheaply in bulk, mix up the carbonated drink right there on the spot and sell the drink for a fairly hefty amount of money and make a tremendous mark up. So you can put 30 cents worth of ingredients into a paper cup and sell it for $ 1.80, and that's a pretty tremendous gain. So although you're not making a lot selling the food, you could make a whole lot selling the drinks, but to do that, you got to persuade the people that the drinks are what they want to drink. They want to order that and drink it. That's the ideal thing for them, and so you push and market the soda very heavily. Everybody wants to drink this soda. This soda is really great because that's where you're making the money is from selling the soda. Selling the food, not so profitable. Selling the soda, enormously profitable.

Slide 4: Profits
Now you can go into a fast food restaurant and order your fast food with milk or order your fast food with juice and what you'll find is that they charge quite a lot for those things and gave you much smaller portions because they really don't want to encourage you to buy those. There's not a huge profit in those things. The huge profit is in selling the soda, and if you are gonna buy them, well they've got to mark the price up enough they make some money on those so they come off fairly expensive for a much smaller portion, and they know that many of the customers will say, " Well, that's too small a portion. I'll just order the soda and I'll have a bigger drink," and that's what they're counting on. That's where the money comes from. So there's a tendency to push people to drink soda and sodas become a very, very big thing, a huge market in the United States. Lots of people drink sodas with every meal and drink sodas between meals now, something that didn't happen in the middle part of the 20th century.

Slide 5: Corn Syrup
One other thing about fountain drinks and sodas that's very interesting and contributes to this whole obesity thing, though, and that is that in the United States sodas are mostly made with high fructose corn syrup as their sweetener, not sugar. Now high fructose corn syrup certainly tastes sweet. High fructose corn syrup is about 2/ 3 of the price of sugar so in terms of just saving money, it's much cheaper to make soda with high fructose corn syrup. But corn syrup does not stimulate the same taste response that actual sugar does, that sucrose does. It's not quite as satisfying to people as sucrose is. If you want to test that out, just find yourself a bottle of a well-known soda, brand name soda that's made with sugar and contrast that with a bottle of the same soda made with corn syrup, and you'll see that the sugar soda is more delicious and more satisfying. Corn syrup is not quite so satisfying. Because the corn syrup is not quite so satisfying, there's probably a tendency for people to drink more of it because it isn't as satisfying to consume. So there's a tendency to drink more soda when it's sweetened with corn syrup than when it is sweetened with sugar. So why you say do we sweeten sodas with corn syrup besides the money issue? Sure, the Benjamins are always important. It's always all about the Benjamins, and money would be enough by itself to use corn syrup to make soda, but sugared sodas do taste better. Why are they sweetening them with corn syrup?

Slide 6: Shelf Life vs. Satisfaction
Well, there's a second reason for this, and that has to do with the shelf life of the syrup that they make soda out of. Those big bags of syrup that you put in a fountain drink dispenser? Soda sweetened with corn syrup has a longer shelf life than soda sweetened with sucrose, with table sugar. And so in terms of being able to stack up a pile of these things and keep them for awhile without them getting a stale taste to them, you do better with corn syrup over the long run, and that longer shelf life means less spoilage, less loss by the people who are dispensing it, and that also means more money. So frankly, even though we would enjoy soda better if it was made with sugar, we instead make sodas with corn syrup. Now, a lot of other countries make their sodas with sugar, and that may indeed make a difference. We may be consuming more soda because it's made with corn syrup than if we were making that soda with sugar. It's hard to say although studies seem to indicate that would be the case.


Obesity in America, Part 3: Insulin, Diet Soda, and Food Cues
Module 8, Video 4
Slide 2: Pancreatic Responses
Now you're saying yes but I drink diet soda so that has no calories, so how is that contributing to obesity? What's true the soda itself is not caloric when you drink diet soda. But when you drink diet soda, when you consume sweet foods it tastes like it's got sugar in it to your body, and your body has this interesting goes on that has do with the anticipation of food coming. You see, for many, many years now you've seen food, you smelled food, you've tasted food, and then sugar started pouring into your blood stream from digestion and your pancreas started making insulin to deal with that sugar. You taste food, you smell food, you see food. The pancreas makes insulin to deal with the sugar. Without very many pairings at all, just the sight of food, the smell of food or the taste of food will already start putting the pancreas into action, making insulin to deal with the sugar it expects to be coming. But when you dump insulin into your blood stream insulin pulls down your blood sugar levels, that's what it's for. It's pulling down your blood sugar levels in anticipation with the sugar that's coming. But that also means it makes you hungrier. As soon as you see food, as soon as smell food, as soon as you taste it, you start making insulin, ven before that food started entering your blood stream, and that starts making you hungrier. So the sight of the food piques your hunger even more than it was before. The smell of the food piques your hunger more. The taste of the food piques your hunger more because you already start making insulin. As you're more hungry you'll consume more food.

Slide 3: Diet Soda
What does that have to do with diet soda? Simply this. When you drink diet soda you are tasting sweet, and your pancreas says sweet stuff is coming and immediately starts making insulin which lowers your blood sugar and makes you hungrier. Then as a result of being hungrier you eat more other food. When you drink the diet drinks you eat more other food. How could you get around this problem? Instead of drinking say, a sweetened drink of any kind with your food, you can drink water which will not make your pancreas start producing insulin and will not make you eat more food. Plus, water also has no calories at all.

Slide 4: The Role of TV
While we are on this subject of you seeing food, and smelling food, and tasting food and then making insulin which makes your appetite even greater let's talk a little bit about television. See, up through the middle of the 20th century there really was no television. Then for a couple of decades the television picture was in black and white or it was in very primitive color. Things didn't look all that great on the television. Food advertising on television was not a problem. But then starting with the 1970s, '80s, '90s, we got better and better televisions with bigger and bigger pictures that were more and more realistic. Now, when you sit down in front of your television at night what do you see? You see incredibly realistic pictures of delicious food being advertised, lovely scrumptious looking stuff being advertised. You see that food, and your pancreas says, " Ooh, food is coming," and starts making insulin. Your blood sugar levels plummet and you say, " Wow, I am hungry." Then you get up and start calling that pizza place on the telephone to order pizza, which is of course why they advertise the pizzas at night on the television, so you'll do that. Even if you don't go and dial up and order pizza you'll probably go looking in the refrigerator for something to eat or looking out in the snack area for your snack chips and you'll consume food that you won't even have thought of consuming if someone hadn't just waved food in your face and made you hungry.

Slide 5: Surrounded by Food!
All the readily available fast food places do that too, all the food dispensers, all of the food trademarks that are up everywhere. You see golden arches, you see particular signs, you recognize that Mrs. Field cookie sign, or that Hardee’s sign or that White Castle burger sign, and you've associated those with eating food too, and your pancreas starts making insulin and you're like, " I am hungry. May be I'll pull over and get some food." You wouldn’t have been hungry if you hadn't seen the logo or the sign. What we've got is all of these things provoking hunger in us that isn't real hunger. We are not actually deprived of food, but we are being persuaded we are hungry by the sight of all this food around us all the time. That’s something grandpa didn't have to deal with, being constantly surrounded by temptations to eat food, and many people give in to those temptations and go ahead and eat the food.


Anorexia Nervosa
Module 8, Video 5
Slide 2: Anorexia Nervosa
So on the one hand, you've got the majority of Americans having a problem with being overweight. And then you've got this minority of people who are clear the other direction. They're way underweight. Now we're talking about people with Anorexia Nervosa, and other eating disorders. Where the person is not taking in enough food to maintain health. Anorexia Nervosa is an odd thing to have in the middle of a culture where obesity is our biggest problem. And yet, there are anorectics around and those anorectics occasionally become ill and die of anorexia. And it raises a whole issue of why is anorexia occurring? Why is it that people are literally starving themselves to a dangerous level in order to appear deathly thin?

Slide 3: Standards of Beauty
One factor that plays a role in Anorexia for at least some people, is the societal standard of beauty. Just what does our society consider an example of a beautiful person? What is the best way to look incredibly beautiful? Now our examples of beautiful males, of very good- looking males, tend to involve people who are very well built, broad shoulders, fairly muscled, have a 6- pack. Those kinds of things can't be obtained by starving yourself. You actually have to engage in exercise and work out to get that kind of a build. Of course that does lead some males to do things like use steroids, but it doesn't tend to lead them to be anorectic. On the other hand, our society standard of beauty for females is another matter. Because our standard of beauty for females is people who are stick- thin; very tall, willowy and incredibly thin people. This is what our models look like. This is what the standards of beauty our actresses are presenting look like. And this is a standard of beauty many girls grow up seeing as this is what an attractive female should be like. Now it hasn't always been like this. The stick- thin model trends started in the 1970's and wasn't really common before that. Clothing designers started realizing in the 1970's that they could drape clothing more smoothly and give clothing more flowing lines on very, very thin people, where the people's figure wouldn't interfere with the lines of the clothing. And so, the first really famous thin model was Twiggy. Who would actually be considered slightly heavy by today's model standards, but was much thinner than models up to that point. And after that, fashion designers moved to thinner and thinner models to this point, that your average fashion design model has got to be about 5 foot 9 and weigh less than 100 lbs. And boy, that is thin.

Slide 4: Standards of Beauty
Now if we look at standards of beauty from the past, some interesting things come out. For example, if you look at standards of beauty among Renaissance artists, you look at people like Rubens, for example. There's a word for females that are carrying a little bit of extra weight, and that's Rubenesque. Because Ruben's figures were often Rubenesque. But so were Raphael's figures. A lot of people depicting very beautiful women as somewhat heavy if they were making pictures of goddesses for example, they would depict those goddesses as being voluptuous; having a little bit of fat, having curves. That was the standard of beauty in those days. But of course in those days, well- fed women tended to be wealthy women, healthy women. People who were in really good shape. And under- fed people looked scrawnier and thinner, and that was associated with a negative aspect of beauty. But as we moved on in the 20th Century, we still liked females to be more voluptuous, more shapely. If you look at the movie stars of the 1940's and 50's, they were very voluptuous women. They were women who had curves. They were women who had just a little body fat on them. They were women who had actual thighs. And they were considered extremely attractive for being that way. I always think of Marilyn Monroe in this regard. Because Marilyn Monroe was considered one of the most beautiful women of her generation. And yet Marilyn Monroe was only 5 foot 5 and a half inches tall. And at her very lightest, weighed 118 lbs. And weighed up to 140 at other points in her life. When she died, and they cleaned out her closet of her clothing, the things she was currently wearing, she had clothing that ranged between sizes 8 and 12. She would have been considered much too large for today's modeling jobs, where the average model wears a size 0. So certainly standards of beauties have changed. And standards of beauty are reflected in the kind of models that you see.

Slide 5: Fashion Dolls
And then there were fashion dolls like Barbie. Barbie is an interesting enigma, because nobody actually knows what Barbie's measurements are, or how much Barbie weighs, because nobody knows how tall Barbie is. Mattel has never specified Barbie's height. Probably quite deliberately. Although if you stand her up beside Ken, she is shorter than Ken. So she ... Assuming Ken is a decently, normally- sized human being, Barbie's probably a fairly average size woman in height. But nobody really knows how tall Barbie is supposed to be. But given Barbie's figure, she's ridiculously thin. Now, Barbie used to be thinner than she currently is. From about 2000 onward, Mattel heard the complaints of people saying, Barbie was so thin she was promoting anorexia, and Mattel made Barbie's waist just a little bit wider. So Barbie's not as thin as she used to be. But Barbie's still ridiculously thin. Barbie's waist- to- hip ratio is somewhere in the neighborhood of . 55. Which is a very unusual ratio in human beings. But Barbie's more of an enigma in this other way. Very interesting thing about Barbie. We don't know Barbie's height, like I say. So it's kind of hard to calculate Barbie's measurements. But if Barbie was 6 foot 1, she would have a chest size, her breast measurements would be about 39 inches. And her waist would only be 19 inches; the old style Barbie would. So she'd have a 39 inch chest and 19 inch waist. And physiologists will tell you in human beings, that is darn near impossible; not in any natural way. Because to slim your waist down to just 19 inches, you would have to lose body fat from all over your body. And breasts are made of fat. If a woman thinned down to a point where her waist was that thin, her breasts would be much smaller than that. Of course you know how fashion models deal with that problem. They slim their waist down that thin and then they get breast implants to have enormous- looking breasts with that small waist. Which is a very artificial way, of course, to look attractive as a female. And that's the standard beauty that girls grow up seeing in United States today.

Slide 6: Male/Female Differences
Now as your textbook points out, in considering being very, very thin in the ideal way to appear, females are probably not in accord with males. That is, if you ask males what they consider the ideal female figure, and then you ask females what they consider the idea female figure, males' ideal female figure is not as thin as what females consider the ideal female figure. Males would actually like the females in their lives to be a little bit heavier than the females think they ought to be. So males' view of how the females in their lives should look, is actually closer to normal human dimensions, than what females think that they ought to look like. What we can say is females have a distorted view of how they should look. In that they think the ideal female figure is a figure that most males would report as too thin. And most males would like to see that figure a little bit heavier. So if you're trying to diet yourself down to some ideal figure, that is ridiculously low like that, it's not surprising it would encourage at least some people to be anorexic.