1. Psychological Disorders
Chapter 12
Psychological Disorders

2. MODULE 37: Normal Versus Abnormal: Making the Distinction
How can we distinguish normal from abnormal behavior?
What are the major perspectives on psychological disorders used by mental health professionals?
What are the major categories of psychological disorders?

3. Defining Abnormality
Behavior that causes people to experience distress and prevents them from functioning in their daily lives
Deviation from the average
Deviation from the ideal
A sense of personal discomfort
The inability to function effectively
A legal concept

4. Figure 1 - Perspectives on Abnormality

5. Perspectives on Abnormality: From Superstition to Science
Medical perspective
Hormonal imbalance
Chemical deficiency
Brain injury

6. Perspectives on Abnormality: From Superstition to Science
Psychoanalytic perspective
Abnormal behavior stems from childhood conflicts over opposing wishes regarding sex and aggression
Behavioral perspective
The behavior itself is the problem
Uses basic principles of learning

7. Perspectives on Abnormality: From Superstition to Science
Cognitive perspective
People’s thoughts and beliefs are a central component of abnormal behavior
Humanistic perspective
Emphasizes the responsibility people have for their own behavior, even when such behavior is abnormal
Carl Rogers and Abraham Maslow

8. Perspectives on Abnormality: From Superstition to Science
Sociocultural perspective
Assumes that people’s behavior is shaped by the society and culture in which they live

9. DSM-V: Determining Diagnostic Distinctions
DSM-V: Used to diagnose and classify abnormal behavior
Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition

10. DSM-V: Determining Diagnostic Distinctions
Axis I: Clinical Disorders
Axis II: Personality Disorders and Mental Retardation
Axis III: General Medical Conditions
Axis IV: Psychosocial and Environmental Problems
Axis V: Global Assessment of Functioning

11. Figure 2 - Major Diagnostic Categories

12. Figure 2 - Major Diagnostic Categories

13. DSM-V: Determining Diagnostic Distinctions
Benefits
Provides a descriptive system
Allows communication between mental health professionals and theoretical approaches
Precise classification enables researchers to explore the causes of a problem
Provides a shorthand through which professionals can describe the behaviors that tend to occur together in an individual

14. DSM-V: Determining Diagnostic Distinctions
Conning the classifiers - The shortcomings of DSM
David Rosenhan (1970s)
Sought admission to mental hospitals based on statement that he or she was hearing voices
Pseudo-patients acted in a normal way after that and the hospitals still diagnosed them as severely abnormal
After an initial diagnosis, mental health professionals overlook other diagnostic possibilities

15. MODULE 38: The Major Psychological Disorders
What are the major psychological disorders?

16. Anxiety Disorders
Occurrence of anxiety without an obvious external cause that affects daily functioning
Four major types
Phobic disorder
Panic disorder
Generalized anxiety disorder (GAD)
Obsessive-compulsive disorder (OCD)

17. Figure 1 - Phobic Disorders

18. Anxiety Disorders
Phobic disorder: Intense, irrational fears of specific objects or situations
Social phobia
Fear of strangers

19. Anxiety Disorders
Panic disorder: Takes the form of panic attacks lasting from a few seconds to several hours
Panic attacks
Anxiety suddenly rises to a peak and one feels a sense of impending, unavoidable doom
Can last from a few seconds to several hours
Agoraphobia
Fear of being in a situation in which escape is difficult and help is unavailable

20. Anxiety Disorders
Generalized anxiety disorder: Long-term, persistent anxiety and worry
Free-floating anxiety
Often accompanied by physiological symptoms such as:
Muscle tension
Headaches
Dizziness
Heart palpitations
Insomnia

21. Anxiety Disorders
Obsessive-compulsive disorder: Characterized by obsessions or compulsions
Obsession: Persistent unwanted thought or idea that keeps recurring
Compulsion: Irresistible urge to repeatedly carry out some act that seems strange and unreasonable
Posttraumatic stress disorder - Person re- experiences a stressful event in vivid flashbacks

22. Anxiety Disorders The causes of anxiety disorders Genetic Factors
Overactive Autonomic Nervous System
Biological Causes
Learned response to stress
Environmental Factors
Inappropriate and inaccurate thoughts and beliefs about circumstances in a person’s world
Cognitive Perspective

23. Somatoform Disorders
Psychological difficulties that take on a physical (somatic) form, but for which there is no medical cause
Hypochondriasis: Constant fear of illness and a preoccupation with one’s health

24. Somatoform Disorders
Conversion disorder: Actual physical disturbance such as the inability to use a sensory organ or the complete or partial inability to move limbs
Cause is purely psychological

25. Dissociative Disorders
Characterized by the separation of different facets of a person’s personality that are normally integrated

26. Dissociative Disorders
Dissociative identity disorder (DID): Person displays characteristics of two or more distinct personalities
Formerly called multiple personality disorder
Controversial diagnosis

27. Dissociative Disorders
Dissociative amnesia: Significant, selective memory loss
Forgotten material is still present in memory but is repressed
Dissociative fugue: Individual leaves home and sometimes assumes a new identity
After a period of time, they suddenly realize and forget the time spent wandering

28. Mood Disorders
Disturbances in emotional experience that is strong enough to intrude on everyday living
Major depression: Severe form of depression that interferes with concentration, decision making, and sociability
Women more likely to experience major depression

29. Mood Disorders Mania: Extended state of intense, wild elation
Bipolar disorder
Formerly known as manic-depressive disorder
Periods of alternating mania and depression
May occur over a few days or over a period of years
Periods of depression are usually longer than manic periods

30. Causes of Mood Disorders
Genetic and biochemical roots
Result of feelings of loss or of anger directed at oneself
Psychological causes
Stresses of life produce a reduction in positive reinforcers
Behavioral theories
Response to learned helplessness
Faulty cognitions (Aaron Beck)
Cognitive factors
Evolutionary psychology

31. Schizophrenia
Refers to a class of disorders in which severe distortion of reality occurs
Characteristics
Decline from previous level of functioning
Disturbances of thought and speech
Formal thought disorder
Delusions
Hallucinations and perceptual disorders
Emotional disturbances
Withdrawal

32. Primary Courses and Symptoms of Schizophrenia
Process schizophrenia
Symptoms develop slowly and subtly
Reactive schizophrenia
Symptoms are sudden and conspicuous
Type I Schizophrenia
Positive symptoms are dominant
Type II Schizophrenia
Negative symptoms are dominant

33. Schizophrenia Solving the puzzle of schizophrenia: Biological causes
Genetic factors
Structural abnormalities
Dopamine hypothesis

34. Figure 8 – Genetic Factors Contributing to Schizophrenia

35. Schizophrenia Environmental perspectives on schizophrenia
Emotional and communication patterns of the families of people with schizophrenia
Expressed emotion - Interaction style characterized by high levels of criticism, hostility, and emotional intrusiveness within a family
Cognitive perspective
Overattention or underattention to stimuli in the environment

36. Schizophrenia The multiple causes of schizophrenia
Predisposition model of schizophrenia - Inherit a predisposition or an inborn sensitivity to schizophrenia
If stressors are strong, and are coupled with a genetic predisposition, they result in the appearance of schizophrenia

37. Personality Disorders
Characterized by a set of inflexible, maladaptive behavior patterns that keep a person from functioning appropriately in society

38. Personality Disorders
Antisocial personality disorder
Show no regard for the moral and ethical rules of society or the rights of others
Lack guilt or anxiety about their wrongdoing
Impulsive and lack the ability to withstand frustration
Extremely manipulative
May have excellent social skills
Con artists

39. Personality Disorders
Borderline personality disorder
Difficulty developing a secure sense of who they are
Tend to rely on relationships with others to define their identity
Emotional volatility leads to impulsive and self- destructive behavior
Feel empty and alone

40. Personality Disorders
Narcissistic personality disorder
Characterized by an exaggerated sense of self- importance
Expect special treatment from others
Inability to experience empathy for others

41. Childhood Disorders
Attention-deficit hyperactivity disorder (ADHD): Marked by inattention, impulsiveness, low tolerance for frustration, and generally a great deal of inappropriate activity
Produced by dysfunctions of nervous system
Autism: Severe developmental disability that impairs children’s ability to communicate and relate to others

42. Other Disorders Psychoactive substance-use disorder
Alcohol use disorders
Anorexia nervosa
Bulimia
Binge-eating disorder
Eating disorders
Sexual desire disorders
Sexual arousal disorders
Paraphilias
Sexual disorders
Organic mental disorders

43. MODULE 39: Psychological Disorders in Perspective
How prevalent are psychological disorders?
What indicators signal a need for the help of a mental health practitioner?

44. Figure 1 - Sample of Prevalence

45. Figure 1 - Sample of Prevalence

46. The Social and Cultural Context of Psychological Disorders
Most recent version of DSM termed controversial
Disruptive mood dysregulation disorder - Symptoms can be that of a child throwing a tantrum
Binge eating disorder - Critics find new classification to be overly inclusive
Other cultures might include a list of disorders that are very different from the list that appears in the current DSM