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Psychological Disorders
Copyright © 2005 by The McGraw-Hill Companies, Inc. All rights reserved.
1
Discuss:
What is your definition of
“abnormal behavior”? Or, what
constitutes abnormal behavior?
What is “normal behavior”?
Copyright © 2005 by The McGraw-Hill Companies, Inc. All rights reserved.
13-2
Instructions: Write "A" over the blank if you think that the behavior being described can be
classified as abnormal, and "N" if you believe that it is reasonably normal.
1. A pregnant woman is so afraid of sleeping near a window as she believes that a
manananggal will come to take her unborn baby away. She is able to sleep well for as
long as she stays away from any opening in their house.
N Although this behavior may constitute delusional thinking in some cultures, it is a
widespread folk belief in our culture. Most Filipino professionals will not consider this
abnormal for as long as there is no impairment in functioning, and the pregnant
woman is not preoccupied with the thought that her unborn child will be taken.
2. When he was a young child, Kenneth witnessed a violent fight between his father
and mother, which eventually led into their separation. At that point, a bird flew
right before him. Since then, he would tremble in fear at the sight of any kind of bird.
In other situations, however, he seems to function like everyone else.
A This is an example of a phobia. Many irrational fears like this are strictly confined to
the target object, which have been associated with the traumatic event.
3. Whenever he comes home, Jon has the routine of going through each room in his
house cleaning and fixing every single fixture. His routine often takes him about 2
hours although he has a domestic helper who cleans his house everyday.
A Some people who suffer from obsessive compulsive disorder may manifest this
behavior. They feel that they need to be clean, and their surroundings neat at all times,
even if their routines take up so much of their time. They just can't help themselves.
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Ben is only 7 years old. He saw a nice, expensive ballpen lying around the living
room of his uncle's house. He took it home without asking permission. When
asked by his parents where he got the pen, he casually (and guiltlessly) answered
where.
N Although many parents may consider this stealing, it is actually not. A child
developmentally needs to learn a sense of proprietorship, and can have some
lapses like this. Children who steal habitually usually fear being reprimanded,
and so lie about the origin of the object in question.
4.
5. Henry is now 10 years old. He has been having school problems since he was
younger, as he cannot keep still in his seat. While listening to the teacher's
lecture, Henry's attention cannot be sustained, so he starts talking to his
seatmates, draws on his notebook, or stands up and goes around the classroom.
During a 40-item test, Henry was only able to complete 10 items in the test,
despite demonstrating adequate understanding of the instructions.
A Henry shows some symptoms of a child suffering from AttentionDeficit/Hyperactivity Disorder: inattention, hyperactivity and impulsiveness.
6. Jenny firmly believes that there is a family of duwendes living in her backyard.
She often leaves toys and food outside for them to enjoy.
N Belief in duwendes is accepted in our culture. Moreover, for as long as this belief
does not disrupt the everyday functioning of the people in her household, this
may not be considered a delusion.
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A
7. Gina is devastated and attempts to commit suicide by slashing her wrists
with a blade after her boyfriend broke up with her.
Although this attempt appears to be a call for attention, it is an act
characterizing a person who is highly unstable. While suicides are usually
associated with people who are feeling depressed, it is also a symptom of people
who suffer from Borderline Personality Disorder.
N
8. Troy often forgets his things. He usually comes to school without his
homework, and often loses his ballpens and notebooks.
Although this forgetfulness can be a form of cognitive loss that may be due to
another medical condition, it cannot be considered a mental illness on its own.
There are some techniques that can be used by Troy in order to overcome his
absent-mindedness.
9. Everyday for the past 2 months, after coming home from work, Ronnie locks
himself in his bedroom and takes shabu while watching television. All his
salary goes to the drugs. He then wakes up early to go to work the next day and
takes pains to ensure that no one finds out about his drug abuse.
A Although Ronnie's work may not seem to be affected by his drug abuse, other
areas of his life are already negatively affected by his addiction: his inability to
stop spending his salary all on drugs, his social isolation by spending all his free
time alone in his room, and lying to others about his drug abuse by making sure
that no one finds out.
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10. When she is in a bad mood, which is almost every day, Tina cannot
help but exhibit temper tantrums.
A This volatile emotionality can be seen among many people suffering
from Borderline Personality Disorder or an impulse control problem.
They are easily provoked, and have difficulty controlling their anger.
11. When asked what her name was, Abel answered that the "moon
jumped together with the sun over the rainbow".
A This shows disorganized thought as a disturbance in the form of
thought of a person suffering from Schizophrenia.
12. Without any effort to diet, Lily loses at least 5% of her body weight
every month for a period of about 3 months.
A Depression usually brings about either a sudden weight gain or loss.
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Abnormal behavior
 What is abnormal behavior?
 Deviation from statistical norms

Ex. Extremely low IQ scores
 Deviation from social norms
 Maladaptiveness of behavior


Ineffective, unproductive, unlawful
Affect daily functioning/relationships
 Level of personal distress
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13-7
Abnormal behavior
 What is normal behavior? (“well-adjusted”)
 Efficient perception of reality
 Ability to exercise voluntary control over behavior
 Ability to form affectionate relationships
 Productivity
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Attention deficit in an 8-year old child –
A) statistical deviation – a behavioral symptom of AD/HD in children, 8year olds are developmentally expected to be able to focus on tasks for
at least 15 minutes, so this is an atypical lag for a child this age
Depression –
D) personal distress – a person suffering from depression may feel
anxious, numb, have loss of appetite, and may have some aches and
pains.
Loss of memory of one’s childhood –
A) statistical deviation – A symptom of DID, this may not cause personal
distress and may not be maladaptive, but it is certainly statistically
uncommon for people not to remember whole chunks of their
childhood
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Frequent alcohol intoxication –
A) social norms - Social norms encourage drinking only in moderation;
frequently getting intoxicated from alcohol is unacceptable
Preference to be alone and avoid any social contact –
C) maladaptive behavior – “No man is an island” as the song goes;
human beings are also social beings as they contribute something to
keep society progressive and productive; by preferring to be alone and
avoiding social contact, the person deprives oneself and society of
maximizing his or her gifts and talents
Belief that one is sick and needs medical attention even when there
are no physical evidence to support this –
C) maladaptive behavior – only persons who are truly sick will seek
intervention for their illness
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Early explanations of mental illness
Early Explanations of Mental Illness
 In ancient times holes were cut in an
ill person’s head to let out evil spirits
in a process called trepanning.
 In the Middle Ages, the mentally ill
were labeled as witches.
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Copyright © 2005 by The McGraw-Hill Companies, Inc. All rights reserved.
Understanding Psychological Disorders
 Theoretical Approaches to Psychological
Disorders
 The Biological Approach

Medical Model
 Structural Views
 Biochemical Views
 Genetic Views
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13-12
Understanding Psychological Disorders
 Theoretical Approaches to Psychological
Disorders
 The Psychological Approach



Psychoanalytic Perspective
Behavioral and Social Cognitive Perspective
Humanistic Perspective
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13-13
Understanding Psychological Disorders
 The Causes of Psychological Disorders
 Sociocultural Factors
 An Interactionist Approach: Bio-PsychoSocial
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13-14
Culture-Related Disorders
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13-15
LO 14.7 Types of psychological disorders
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LO 14.7 Types of psychological disorders
Menu
Copyright © 2005 by The McGraw-Hill Companies, Inc. All rights reserved.
DSM: Classifying Abnormal Behavior
 DSM-IV
 Stands for Diagnostic and Statistical Manual of
Mental Disorders, fourth edition; the most recent
major classification of psychological disorders.
 Classifying Abnormal Behavior
○
Axis I: All Categories Except Personality Disorders and
Mental Retardation

○
Axis II: Personality Disorders and Mental Retardation

○
physical
Axis IV Psychosocial and Environmental Problems

○
other long-standing psych condition
Axis III: General Medical Conditions

○
primary diagnosis
personal difficulties/stressful events that precipitated
disorder
Axis V Current Level of Functioning

On a scale of 100: assess general level of functioning
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DSM
 Diagnostic Categories

Disorders usually first diagnosed in infancy, childhood, or
adolescence
○
Mental Retardation


○
Learning Disorders

○
lag in reading, writing, math
Pervasive Developmental Disorders


○
IQ tests
Usually genetic factors, head trauma, infection, toxic substances
severe impairment, odd behavior
Ex. Autism – hand-flapping, poor eye contact, prefer to play alone
- High-functioning autistic – may attend regular schools
- Savant
Attention-Deficit/Hyperactivity Disorder (ADHD)

Lack of focus, hyperactivity, poor impulse control
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DSM

Delirium, dementia, amnestic, & other cognitive disorders
Impairment of brain functioning (aging etc.)


Mental disorders due to a general medical condition
Consequence of a medical condition


Substance-related disorders
Effects of meds, drug abuse, toxic substances


Schizophrenia and other psychotic disorders



Impairment of reality testing, bizarre behavior, highly disordered
thought processes
Delusions (false beliefs)
- “I am Napoleon!”
Hallucinations (false sensory perceptions)
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Schizophrenia
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13-21
Schizophrenia
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Probability of Developing
Schizophrenia
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13-23
Schizophrenia
 Causes of Schizophrenia
 Biological Factors



Heredity
Structural Brain Abnormalities
Neurotransmitter Deregulation
 Psychological Factors

Diathesis-Stress Model
 Sociocultural Factors
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13-24
Mood disorders
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DSM

Mood disorders



Psychological disorders in which there is a primary
disturbance in mood. Prolonged emotion that colors the
individuals entire emotional state. Two main types are the
depressive disorders and bipolar disorder.
Depressive disorder – sadness, loss of gratification, negative
thoughts, lack of motivation
Bipolar disorder – alternate bouts of depression & mania
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DSM

1.
2.
3.
4.
5.
6.
7.
8.
9.
Major Depressive Disorder – must have 5 of the 9
symptoms during a 2 week period
Depressed mood for most of the day
Reduced interest or pleasure in most activities
Significant weight loss or gain, significant decrease
or increase in appetite
Trouble sleeping or sleeping too much
Psychomotor agitation or retardation
Fatigue or loss of energy
Feeling worthless or guilty in an excessive or
inappropriate manner
Problems thinking, concentrating, or making
decisions
Recurrent thought of death or suicide
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DSM
Depression/Mood Disorders



















Psychoanalytic
Reaction to loss; anger towards self
Behavioral
Lack of positive reinforcement
Negative experiences throughout life
Learned Helplessness
Cognitive
How people view themselves or the world
Biological
Heredity
Neurophysiological Abnormalities
Neurotransmitter Deregulation
Hormones
Sociocultural Factors
Interpersonal Relationships
Socioeconomic and Ethnic Factors
Cultural Variations
Gender
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Mood Disorders
• Major Depressive Disorder
Gender Differences in Depression
Across Cultures
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Mood Disorders
Bipolar
Disorder
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Anxiety Disorders
Menu

Anxiety disorders

DSM
○
○
○
○
○
include these features: motor tension, hyperactivity,
and apprehensive expectations and thoughts.
Generalized Anxiety Disorder An anxiety disorder that
consists of persistent anxiety for at least one month;
the individual with this disorder cannot specify the
reasons for the anxiety.
Panic Disorder An anxiety disorder marked by the
recurrent sudden onset of intense apprehension or
terror.
Agoraphobia A cluster of fears centered around public
places and being unable to escape or find help should
one become incapacitated.
Phobic Disorder Commonly called phobia, an anxiety
disorder in which the individual has an irrational,
overwhelming, persistent fear of a particular object or
situation.
Obsessive-Compulsive Disorder (OCD) An anxiety
disorder in which the individual has anxiety-provoking
thoughts that will not go away (obsession) and/or
urges to perform repetitive, ritualistic behaviors to
prevent or produce some future situation
(compulsion).
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Anxiety Disorders
 Post-Traumatic Stress Disorder (PTSD)
 PTSD Symptoms
 Combat and War-Related Traumas
 Abuse
 Natural and Unnatural Disasters
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13-33
Phobias
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13-34
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DSM





Anxiety disorders
Psychoanalytic

Punitive disciplining strategy while
toilet-trained
Behavioral

Phobia was a learned response
Cognitive

Thoughts? Overestimation of the
feared event. Belief that rituals will
prevent disaster.
Biological
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DSM

Somatoform disorders


Physical symptoms with no biological basis
Factitious disorders


Intentionally feigning symptoms with no apparent gain
Dissociative disorders

Psychological disorders that involve a sudden loss of
memory or change in identity.
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DSM

Dissociative disorders



Dissociative Amnesia A dissociative disorder involving
extreme memory loss caused by extensive psychological stress.
Dissociative Fugue A dissociative disorder in which the
individual not only develops amnesia but also unexpectedly
travels away from home and establishes a new identity.
Dissociative Identity Disorder (DID) Formerly called multiple
personality disorder, this is the most dramatic but least
common dissociative disorder; individuals suffering from this
disorder have two more distinct personalities or selves.
Copyright © 2005 by The McGraw-Hill Companies, Inc. All rights reserved.
DSM

Dissociative disorders


Many have experienced sexual or physical abuse as children
Why create new identities in such a situation?
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DSM

Sexual & gender identity disorder


Distress over sexual identity, sexual performance
Eating disorders


Self-induced starvation, binge eating, innaccurate
perception of body image
Sleep disorders
Impulse control disorders


Anger, gamble, set things on fire, pull one’s hair, steal
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DSM

Adjustment disorders


psychological response from an identifiable stressor or
group of stressors that causes significant emotional or
behavioral symptoms that does not meet criteria for more
specific disorders
like loss of a boyfriend, a poor report card, or moving to a
new
Copyright © 2005 by The McGraw-Hill Companies, Inc. All rights reserved.
DSM

Personality disorders




Chronic, maladaptive cognitive-behavioral patterns that
are thoroughly integrated into the individual's personality.
Paranoid

Sensitivity to rejection, resentfulness, distrust, as well
as the inclination to distort experienced events.
Neutral and friendly actions of others are often
misinterpreted as being hostile or contemptuous.
Histrionic

attention-seeking and excessively dramatic behaviors
Narcissistic

grandiose sense of self-importance; preoccupied with
fantasies of unlimited success, power, brilliance,
beauty, or ideal love ; sense of entitlement
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DSM

Personality disorders








Antisocial
lack of remorse, morality  commit crimes
Passive-aggressive
Pattern of negativistic attitude, passive resistance
to perform adequately
Procrastination, stubbornness, and forgetfulness
Borderline
psychological instability, fear of abandonment;
have unstable moods, relationships; high number
experienced abuse as children
Other conditions that may be the focus of
clinical attention
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Neurotic? Or Psychotic?
 Neuroses – feelings of anxiety etc.
 Psychoses – loss of contact with reality
 Delusions (false beliefs)
 Hallucinations (false sensory perceptions)
○
Ex. Dr. John Nash
 Ex. Psychotic depression, Neurotic depression
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DSM
 Evaluation
 Use of Labels

The medical model
 disease
 Culture
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Explaining Abnormal Behavior
 Biological perspective
 Ex. Depression (Psychiatrist, Psychologist)
 Psychoanalytic perspective
 Unconscious conflicts/ maladaptive use of defense mechanisms
 Behavioral perspective
 Learned
 Cognitive perspective
 mental processes
 Biopsychosocial approach
 interactionist
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SUICIDE
 Discuss:
 What do you think of people who think of committing
suicide or have actually committed suicide?
 Have you ever had to deal with a friend with suicidal
thoughts?

What did you say to the person?
 Have you personally ever thought of committing
suicide?

If so, how far did you go in terms of thought process or
behavior?
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13-48
Suicide
 Philippines, commonly used:
 Paracetamol
 Bleach
 Pesticides
 Prescription drugs
 Muriatic acid
 Also,

Hanging, shooting oneself, carbon monoxide poisoning
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Suicide
 Usually after a fight with family or
boyfriend/girlfriend
 Not all intend to die
 Hurt someone
 Gain attention
 Release tension
 In the U.S., suicide has quadrupled since 1950
 Girls: 3x more attempts than boys
 Completed suicides: 5x higher among boys than girls
Copyright © 2005 by The McGraw-Hill Companies, Inc. All rights reserved.
Suicide

Instructions: Write "T" over the blank if you think that the behavior being described is true and “F” if
you think it is false.
1. People generally think about suicide.
Ordinarily, people think about suicide at one point in time in their lives. This may
happen especially during stressful moments.
2. A person who talks about committing suicide may seriously do it.
While there are people who talk about suicide but do not attempt it at all, those who
have a history of attempts are more likely to do it again. Moreover, if the person
has detailed plans of how one will kill oneself and has easy access to materials
to implement it, the more likely the attempt will be made.
3. A person who commits suicide usually warns others about it.
Usually, a person warns others that he or she is thinking of committing suicide. It
may be as clear as a threat or may be so subtle (i.e. said in a joking manner)
such that it was easily dismissed and realized only in hindsight.
4. A number of people who commit suicide do not actually intend to die.
While there are a number of people who intend to die when they commit suicide,
others do it impulsively to cope with a stressful situation, to gain attention, to
hurt someone back, or to relieve themselves of pain.
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Suicide
5. If one has a history of previous suicide attempts, he may likely do it again.
Those who have attempted suicide in the past are more likely to do so again
especially if proper aftercare and treatment was not given and the person has
not learned better and healthier coping skills needed.
6. It is difficult to identify a person who is likely to commit suicide.
Sudden changes in a person's behavior especially a display of depressive symptoms
may be a warning that he or she wants to commit suicide. At other times,
however, one can barely see any change in behaviors as the person who later
attempts went normally about his or her daily routine right before it.
7. Talking with the person about his or her suicidal thoughts and plans may help
the person abandon his or her plans of actually putting these thoughts into
action.
During this stressful moment, a person who thinks of suicide may be in great need
of someone who shows compassion and care. Being able to talk about it to
someone may also relieve him or her of anxiety and may make him or her feel
understood.
8. A person who commits suicide may suffer from a mental disorder.
Studies show that a number of people who commit suicide are diagnosed to have
depression, borderline personality disorder, schizophrenia, or substance abuse.
With the correct diagnosis, proper treatment may be given to them.
Note: All answers on the worksheet are T for True
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Suicide
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
Instructions: For each of the following brief case studies, identify the disorder.

 1.
Edwina is worried, anxious, and sure that something terrible is going to
happen to her. She’s not sure what it would be, but she “just knows.” The feeling
occurs on almost a daily basis and frequently keeps her awake at night. In
addition, for the last few weeks, she has been plagued with chronic headaches,
upset stomachs, and upper back pain.

 2.
Last week, Roger suddenly quit his job. He told his family he had decided
to learn carpentry. He purchased a truckload of wood and nails, which now sits
in his driveway because he changed his mind and decided to enroll in a school
for massage therapy. The school confirms that he registered but that he has not
attended class. Roger claims that he can learn all he needs simply from reading
the books. For the last three days, he has not slept. He started to read the
massage therapy books but became so upset by the lack of quality photos in the
texts that he bought a camera. Today, he is taking photos for his new career as a
photojournalist.

 3.
George enters the clinic with his wife who says she “can’t take it
anymore!” She states that George is carrying around a notebook in which he is
constantly scribbling cryptic notes about everyone that he meets. He is parking
his car a few blocks away from the house so he can watch who drives down the
street and past his home. Yesterday, he came home early and taped all the
shades down over the windows in the house.

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 4.
Susanna appears in court this morning on check forgery charges. She
is dressed in a black leather miniskirt, thigh-high black boots, a bright red,
low-cut tank top, and earrings with bells that jingle when she moves.
Throughout the proceedings, Susanna methodically files her fingernails.
She adamantly states that she is not to blame for writing the bad checks
despite the fact that she admits to stealing them from her father and
signing his name. She makes it clear that her father owes her the money
because he refused to pay for medical school (despite the fact that she never
graduated from college) and ruined her career as a brilliant physician.

 5.
Anichka was walking her dog when suddenly and without warning,
her heart began to pound, her legs began to tremble, and she became very
dizzy. She was convinced she was having a heart attack right there on the
street.

 6.
Noah is having trouble staying awake at work. Throughout the night
he hears someone that tells him something is on fire in the house. He has
been getting up 15 to 20 times during the night to check for smoke and to
check the smoke alarm.

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
 7.
John is seen in the emergency room because his mother brought
him in. He is dressed in a blue baseball cap, red striped pajamas, army
combat boots, and large women’s clip-on earrings. He claims he has
been “swatting sprocketgens” and “pounding the batjunkins with rose
perfume.”

 8.
Maurice is sleeping 12 to 16 hours a day. Over the last two
months, his weight has dropped 10 pounds, and he feels as if it takes all
his effort to fix a simple bowl of soup. He feels as if he is sitting at the
bottom of a hole and simply can’t climb out.
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