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      Figure 1.1 Prevalence of Any Mental Illness Among U.S. Adults (2014)

      Source: National Institute of Mental Health, http://www.nimh.nih.gov/health/statistics/prevalence/any-mental-illness-ami-among-us-adults.shtml

      There is often a stigma experienced by those with a mental disorder. Historically, stigma has been defined as a mark of disgrace associated with a particular person. In psychological terms, stigma involves negative attitudes and beliefs that cause the general public to avoid certain people, including those with a mental illness. Throughout the world, those with mental illness experience stigma. In many cultures, they are seen as different. When they are thus stigmatized, they are no longer treated as individual people, but only as part of a group who is different. It becomes an “us versus them” way of thinking.

      stigma: negative attitudes and beliefs that cause the general public to avoid certain people, including those with a mental illness

      Part of the stigma comes from inaccurate information concerning those with mental illness. For example, many people think that anyone with a mental illness is violent. In 2012, there was a mass shooting that killed 20 children and 6 teachers at the Sandy Hook Elementary School in Newtown, Connecticut. Immediately after, it was suggested that the killer had a mental illness. Officials of the National Rifle Association claimed that this could not have been done by a sane person. However, the data do not support a strong relationship between mental disorders and violence.

      The MacArthur Foundation followed hospitalized individuals with mental illness after their release and found that only 2% to 3% of them became involved with violence with a gun. As a general rule, individuals with mental illness do not show more violent tendencies than is seen in the general population. However, particular disorders such as psychopathy are associated with serial killers and other violent criminals. Also, substance abuse can increase violence in some individuals. With these exceptions, however, having a mental illness has not been found to increase violence toward others.

      Stigma can be seen on a number of levels. If a society believes that mental illness is the fault of the person—and that the person can change himself or herself by willpower—then it is less likely to spend the money necessary to set up clinics and train professionals. For similar reasons, society may also be less likely to set up school-based programs to help adolescents with bullying or suicide. As well, companies may not be willing to include mental health treatment in their insurance coverage, or they may place limits on benefits for treatment of these disorders. In the United States, attitudes are moving toward less stigma. In 1996, for example, 54% of the U.S. population viewed depression as related to neurobiological causes. During the next 10 years, this increased to 67%. With a better understanding of the disorders presented throughout this book, it is possible to have a more compassionate as well as intellectual understanding of those with mental disorders.

      As a society, Americans demonstrate a number of different values when considering those with mental illness. On the one hand, we may want to help those who experience distress. On the other hand, we may feel it is their responsibility to take care of themselves. LENS: American Attitudes Toward Mental Illness, portrays some of these differing values.

      Concept Check

      behavioral and experiential perspective: examines the behavior and experience observed in psychopathology, especially the manner in which the signs and symptoms of a particular disorder are seen in a similar manner throughout the world

      The Three Major Themes of This Book

      In this book, I will explore three major themes. The first theme takes a behavioral and experiential perspective on psychopathology. Here, I will examine current ways of classifying and describing abnormal behavior. I also want you to consider the experience of having a psychological disorder and will present first-person reports from individuals with particular disorders. We will also discuss symptoms and signs. Traditionally, symptoms, such as feeling sad, are seen as subjective, and may be reported by the individual to a professional, whereas signs, such as having a fever, are an objective process that can be measured and would be apparent to a professional. An important aspect of this perspective is the manner in which the signs and symptoms of a particular disorder are seen in a similar manner throughout the world. The universality of mental disorders has been an important consideration for scientists. It is also important to note the role culture plays in the manifestations of behaviors and experiences related to psychopathology.

      The second theme examines what we know about particular psychopathological experience from a neuroscience perspective. In particular, I will emphasize the structure and function of the brain as it relates to psychopathology. With the advent of neuroscience techniques such as brain imaging, it is becoming clear that mental disorders are also brain disorders. In fact, with every disorder we will consider in this book, it is possible to examine the manner in which the structure and function of the brain is changed. The neuroscience perspective will also help us to consider how certain disorders share a similarity in underlying brain processes. For example, knowing that the same brain networks involved in physical pain are also involved in social rejection helps us understand the experience of each and how they are similar.

      The third theme asks much broader scientific questions and examines psychological disorders from an evolutionary perspective. In adopting this perspective, we can think about how certain ways of seeing or being in the world might be adaptive. Being afraid of heights, for example, keeps us from taking unnecessary risks. We can ask if there is any advantage to behaving and feeling in certain ways that others consider abnormal. We can also ask if the disordered behavior is secondary to another process that is beneficial. This could include an attempt by our body to protect itself.

      neuroscience perspective: examines what we know about particular psychopathological experience from the standpoint of neuroscience, including the structure and function of the brain, the autonomic nervous system, and a genetic and epigenetic consideration as it relates to psychopathology

      evolutionary perspective: examines psychological disorders in terms of how certain aspects might be adaptive, asking if there is any advantage to behaving and feeling in certain ways that others consider abnormal or if the disordered behavior is secondary to another process that is beneficial

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