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Chapter 12
Psychological
Disorders
What is Normal?
Normal or Abnormal?
Normal or Abnormal?
Normal or Abnormal?
Normal or Abnormal?
Normal or Abnormal?
Normal or Abnormal?
Normal or Abnormal?
Normal or Abnormal?
Normal or Abnormal?
Normal or Abnormal?
Normal or Abnormal?
Defining Psychological Disorders
Psychopathology
– Patterns of thought, emotion, & behavior that are maladaptive,
disruptive or uncomfortable either for the person affected or for
others.
What is Abnormal?
– Statistical infrequency?
• That which is unusual or rare.
– Norm Violation?
• People behave in a way that violate social norms
– Personal Suffering?
• Experiencing personal distress.
• Practical Approach
– Psychologists & researchers use a combination of all criteria.
– 3 C’s = Content, Context & Consequences
– Impaired Functioning – difficulty in fulfilling appropriate &
expected roles in family.
What Causes Abnormality?
Biopsychosocial model
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1.
Biological factors
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2.
Neurobiological or medical model – symptoms of psychological disorders
originate from an illness that can be diagnosed, treated & cured.
Psychological Process
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3.
Psychoanalysis – problems from unresolved, unconscious clashes between
internal desires & environmental pressures.
Social-Cognitive – result of past learning & current situations.
Humanistic – person’s natural tendency toward healthy growth is
blocked by not being aware of or have the ability to express their feelings.
Sociocultural Context
•
•
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4.
Disorders caused by biological, psychological & sociocultural interactions
Gender, age, marital status; economic, physical, social situations people
live in; cultural values, traditions, expectations
Culture-general disorders – appears across cultures
Culture-specific disorders - unique to particular cultural group.
Diathesis-Stress – predisposition & situational factors are
involved.
DSM –
North American Diagnostic & Statistical Manual of Mental
Disorders
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1952 Published to provide clear descriptions of disorders.
Lists 300 specific diagnostic labels w/ the symptoms of disorders.
ICD-10: WHO’s International Classification of Diseases
ICIDH-2: International Classification of Impairments, Disabilities & Handicaps.
Base diagnosis on 5 axes:
1. Primary Clinical Problem
2. Ingrained Aspects of the Clients Personality
3. General Medical Conditions
4. Social and Environmental Problems
5. Global Assessment of the client’s overall level of functioning.
Problems with DSM:
1. Over diagnosis
2. Diagnostic Labels
3. Confusion of Serious Mental Disorders with Normal Problems
4. The Illusion of Objectivity
Anxiety Disorders
Types of Anxiety Disorders:
•Phobias, Generalized anxiety disorder, Panic Disorder,
Obsessive-Compulsive disorder, Post-Traumatic Stress Disorder
Anxiety – a general state of apprehension or psychological tension.
Fear – apprehension about a specific fear.
Generalized Anxiety Disorder – long-lasting anxiety, not focused on
any particular object or situation – general feeling dread or fear.
• Symptoms – Restlessness, Feeling keyed up, being easily fatigued,
difficulty concentrating, irritability, muscle tension and jitteriness
and sleep disturbance.
• Data – 3.4% in US population & 5% Internationally & more
common in women.
Fears and Phobias
Phobia – exaggerated fear of a specific situation, activity, or thing.
Types of phobia –
acrophobia = fear of heights
bronophobia = fear of thunder
claustrophobia = fear of closed spaces
social phobia = persistent fear of situations in which they will
be observed by others.
Most Disabling Phobia is “Fear of Fear” or agoraphobia.
Agoraphobia = being alone in a public place, where escape might be
difficult or where help might be unavailable – fear of being away
from a safe place.
Panic Disorder
Recurrent & sudden panic attacks w/ feelings of
impending doom
May lead to agoraphobia
Symptoms- trembling & shaking
- dizziness, chest pain, or discomfort, heart palpitations
- feelings of unreality, hot and cold flashes, sweating
- fear of dying, going crazy, losing control
Obsessions and Compulsions
Obsessive – Compulsive Disorder (OCD)
Obsession -Characterized by recurrent, persistent, unwished-for
thoughts or images,
• these thoughts motivate repetitive behaviors called
compulsions.
Compulsions – repetitive, ritualized, stereotyped behaviors that the
person feels must be carried out to avoid disaster that will prevent
events resulting from Obsessions.
Posttraumatic Stress Disorder (PTSD)
- When people survive an uncontrollable & unpredictable
dangers
Symptoms- reliving trauma
- intrusive thoughts & dreams
- psychic numbing
- increased psychological arousal difficulty
concentrating, insomnia, irritability
Mood Disorders
When is depression more then just feeling “down”?
When it goes beyond ordinary sadness over life’s problems.
Depression
Referred to as “common cold of psychology”
Dysthymia
is chronic sadness or feeling of being “down in the dumps”
Major Depression – involves emotional, behavioral & cognitive changes in
a person.
Mental Symptoms:
- think often of death or suicide
- lose interest or pleasure in their usual activities
- feel unable to get up or do anything
- thinking patterns feed their mood
- exaggerate minor failings & ignore or discount positive events
- depressed people have low self-esteem
Physical Symptoms:
- overeating or stop eating
- insomnia or sleep too much
- lose of sexual desire
- trouble concentrating
- feel tired all the time
Approximately 15% of the population becomes effected by
depression. ½ of all people who go through major depression only go
through it once.
Mania – abnormal high state of exhilaration or feeling too good.
Symptoms are opposite of depression.
- lots of energy
- talks rapidly and dramatically
- full of ambition, plans or power
- exaggerated self-esteem
Bipolar Disorder (Manic-Depressive) – when someone experiences
depression and mania
Effects about 1.5% of population.
Studies suggest women are more likely to be depressed then men.
But: Women are more open then men about their feelings.
Men may get overlooked or misdiagnosed
Men may mask it by taking drugs or violence
Women may have less satisfying work and family lives then men.
Women have higher rates of sexual assaults
Men are 2x’s as likely to be married and have a job then women.
Theories of Depression
1. Biological
a. Emphasize genetics and brain chemistry
2. Social
a. Circumstances of people’s lives
3. Attachment
a. Problems with affiliation and close relationships
4. Cognitive
a. Habits of thinking and interpreting events
5. “Diathesis-stress” approach
a. Draws on all the previous theories.
Personality Disorders
Personality Disorders – rigid, maladaptive trait that causes great
distress or an inability to get along with others.
Not caused by:
-Depression
-Drugs
-Temporary reaction to a situation
Paranoid Personality
- Ongoing, unfounded suspiciousness & mistrust of other people.
- Think they are being persecuted by everyone - from family to the gov’t
- Beliefs are immune to disconfirming evidence.
Narcissistic Personality Disorder
- Exaggerated sense of self-importance & self-absorption.
- Preoccupied with fantasies of unlimited success, power, brilliance or
ideal love.
- Demand constant attention & admiration; feel entitled to special favors
- Fall in and out of love very quickly.
Antisocial Personality (psychopaths or sociopath)
- Lack emotions that connect them with other humans.
- Without conscience and have no regard for the rights of others.
- Often lie, charm, seduce, and manipulate others.
- Sexually promiscuous, unable to maintain attachments
- Many have history of sadistic, criminal or cruel behavior.
- Most common in males rather than females. Men 3-5%, women 1% or
less.
- May account for more than ½ of all crimes.
- Doesn’t respond to punishment.
- May have an abnormal central nervous system.
- Problems in behavioral inhibitions; ability to control responses to
frustrations or inhibit pleasure actions that cause negative consequences.
Reasons for Antisocial Behavior
1. Neurological impairments, resulting
from injury not genetics.
2. Vulnerability - stress model - brain
damage mixed with social deprivation.
3. Being in a culture or environment that
rewards antisocial behavior.
Dissociative Disorder
Dissociation – a split in awareness – feel dazed or strange
Dissociative Disorder - It is a disorder when consciousness, behavior
& identity are altered or split.
Causes :
Daydreaming
Stress or shock
Upsetting or harmful events
These people seem to erase the event from their memory.
Amnesia
- An inability to remember important personal information that
cannot be explained through normal forgetfulness.
Causes:
Traumatic experiences
Brain damage
Dissociative Fugue
- A person in this state forgets his or her identity and also gives up
customary habits and wanders far from home then one day they will
just “wake up” and not remember the fugue state.
- It can last a day or so or several years.
- Hard to determine if someone is faking this or not.
Dissociative Amnesia
- Similar to Fugue but don’t leave home, just memory loss.
Dissociative Identity Disorder (Multiple Personality Disorder)
- The appearance within one person, of 2 or more different & distinct
identities.
2 views on DID:
1. Some say it is common
2. Some say clinicians generate it with vulnerable & suggestible clients.
Causes: 1 View
1. Starts as children as a way to cope with traumas so splits the identity
to deal with it.
2.Frequently described as living with several identities until therapy
helps to define or bring them to light.
Schizophrenia
Schizophrenia – when personality loses its unity or fragmented
condition where words are cut from meaning, actions from
motives, perceptions from reality.
It is an example of psychosis or distorted perception of reality.
Symptoms of Schizophrenia
Two types of symptoms positive or negative
Positive = any addition to the person’s personality
Negative = any loss or absence of personality
Active symptoms
1. Bizarre Delusions (false beliefs)
2. Hallucinations
3. Disorganized, incoherent speech
4. Grossly disorganized or inappropriate behavior
Negative Symptoms
1. Loss of motivation
2. Emotional flatness
3. Poverty of speech due to lack of mental ability not
unwillingness
Theories of Schizophrenia
1. Structural Brain Abnormalities
2. Neurotransmitter Abnormalities
3. Genetic Predispositions
4. Prenatal Abnormalities
5. Vulnerability-stress model