Download Chapter 18 Section 1 Psychological Disorders

Chapter 18 Section 1
Psychological Disorders
Obj: Describe the basis for
classifying psychological
disorders.
What are Psychological
Disorders?
Psychological disorders are behavior patterns or mental
processes that cause serious personal suffering or interfere
with a person’s ability to cope with everyday life.
Many people believe that psychological disorders are
uncommon, affecting relatively few individuals. It is true that
the great majority of people are never admitted to mental
hospitals, and most people never seek the help of
psychologists or psychiatrists. And although many people
have relatives they consider eccentric, few people have
family members they consider to be truly abnormal.
Estimates suggest that one third of the
adults in the US have experienced some
type of psychological disorder. In addition
to the many people with substance abuse
problems, 23 percent of people in the US
experience some type of psychological
disorder in their lifetime. In any given
month, the figure is approximately 13
percent.
Identifying Psychological
Disorders
Deciding whether particular behaviors, thoughts, or
feelings are “normal” or “abnormal” can be
difficult. What is normal is often equated with
what is average for the majority of people. Using
this definition of normality, deviation from the
majority becomes the primary criterion for
abnormality.
People with psychological disorders usually do not
differ much from “normal” people. In fact, the
primary difference is the simple exaggeration of
certain behaviors or mental processes.
Systems of Psychological
Disorders
Several behavior patterns and mental processes may
suggest that an individual has a psychological disorder.
The word suggest is important here because diagnosing
an individual with a psychological disorder is often
difficult, and diagnoses are not always simple or
straightforward.
Psychologists generally use several criteria to determine
whether a person’s behavior indicates the presence of a
psychological disorder. These criteria include how typical
the behavior is of people in general, whether the behavior
is maladaptive, whether the behavior causes the
individual emotional discomfort, and whether the behavior
is socially unacceptable.
• Typicality – the normality of a behavior or mental
process is often determined by the degree to
which it is average, or typical, of the behavior or
mental processes of the majority people. There
are, however, problems with defining normality in
terms of what is typical of most people. The fact
that a behavior is not typical of most people does
not mean it is abnormal. Scientific and artistic
geniuses, such as Marie Curie and Pablo
Picasso, certainly are not typical of people in
general. That does not mean, however, that such
people are abnormal.
• Maladaptivity – Many psychologists believe that what
makes a behavior abnormal is the fact that it is
maladaptive. That is, the behavior impairs an individual’s
ability to function adequately in everyday life. Behavior
that causes misery and distress rather than happiness
and fulfillment may be considered maladaptive. Alcohol
abuse is one such behavior. Alcohol abuse often has
strong negative effects on the drinker’s health, work, and
family life. Abuse of alcohol may discourage the drinker
from seeking healthier solutions to the problem of anxiety
as well as create additional problems of its own.
Behavior that is hazardous to oneself or to others may also
be considered maladaptive. This type of maladaptive
behavior may include threatening or attempting suicide
as well as threatening or attacking other people.
It is important to note that most people who
commit violent crimes do not have
psychological disorders. This is because
most criminals are fully aware of what they
are doing. That is, they know that their
behavior is illegal and that they can be held
responsible for it. Equally important, the
majority of people with psychological
disorders, even severe psychological
disorders, are not violent or dangerous.
• Emotional Discomfort – Psychological disorders
such as anxiety and depression cause most
people great emotional discomfort. For example,
people who are depressed often suffer feelings of
helplessness, hopelessness, worthlessness, guilt,
and extreme sadness. They may lose interest in
virtually everything they once enjoyed and
believe that life is not longer worth living. Such
feelings are so stressful that they may lead the
affected individual to consider suicide. Thus,
severe emotional discomfort may be a sign of a
psychological disorder.
• Socially Unacceptable Behavior – Behavior
that violates a society’s accepted norms may
also be an indication of a psychological disorder.
However whether a behavior is socially
unacceptable may depend on the particular
society or culture in which it occurs. What is
considered normal behavior in one culture may
be considered abnormal in another. Therefore,
the cultural context of a behavior must be taken
into account before deciding that the behavior
indicates a psychological disorder.
The importance of culture is demonstrated by culturebound syndromes, clusters of symptoms that define
or describe an illness. Many behaviors associated
with culture-bound syndromes would be considered
abnormal by people who are unaware of the
syndrome's cultural context. For example, many
people in Middle Eastern cultures believe that certain
inappropriate behaviors, such as banging one’s head,
are due to possession of the body by a spirit. In the
US, such a belief would likely be considered a sign of
a serious psychological disorder. However, in the
cultural context of some areas in the Middle East,
spirit possession is considered to be a rational
explanation of certain types of behavior, and the
affected individual is not thought to have a
psychological disorder.
Classifying Psychological
Disorders
Most psychologists believe that it is important to
have a widely agreed upon classification of
psychological disorders. Unless there is
agreement about how to classify psychological
disorders, it is difficult to know how many people
have a given disorder or what other factors, such
as socioeconomic status, heredity, or gender
differences, may be associated with it. It is also
important to classify psychological disorders so
that individuals can be correctly diagnosed and
treated.
The most widely used classification system for
psychological disorders is the DSM, or Diagnostic
and Statistical Manual of Mental Disorders,
published by the American Psychiatric Association.
The most recent version of the manual, the DSM-IVTR which was published in 1994, recognizes 18
different categories of psychological disorders.
Until 1980, when the third edition of the DSM was
published, psychological disorders were classified on
the basis of their presumed causes. For many
decades, the most widely accepted causes were
those suggested by Freud’s psychoanalytic theory.
Many psychologists criticized early versions of the
DSM because very diverse psychological disorders
were grouped together under the labels “neuroses”
and “psychoses”. As a result, beginning with the
DSM-III in 1980, psychological disorders have been
categorized on the basis of observable signs and
symptoms rather than presumed causes.
The DSM is subject to ongoing revision. New
categories are added and old ones deleted as
knowledge of psychological disorders increases. For
example, post-traumatic stress disorder was added
to the DSM only after the Vietnam War, when many
soldiers were found to suffer from the disorder.
The remainder of this chapter focuses on six
major types of psychological disorders as
classified by the DSM-IV: anxiety disorders,
dissociated disorders, somatoform disorders,
mood disorders, schizophrenia, and
personality disorders. Many symptoms are
simply exaggerations of normal thoughts,
feelings, or behaviors. These symptoms do
not necessarily indicate a psychological
disorder. Psychological disorders can only be
diagnosed by a skilled professional after
careful evaluation.