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Psychological
Disorders
AP Psychology
Mr. Boyd
Abnormal Behavior
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The medical model
What is abnormal behavior?
Deviant
 Maladaptive
 Causing personal distress
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A continuum of normal/abnormal
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We can not draw a “line”.
Figure 14.2 Normality and abnormality as a continuum
Prevalence, Causes, and Course
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Epidemiology-study of the distribution of illness
Prevalence-% of population has illness over time
Lifetime prevalence
Diagnosis-distinguishing one from another
Etiology-apparent cause/development
Prognosis-forecast of the probable course
Figure 14.5 Lifetime prevalence of psychological disorders
Psychodiagnosis:
The Classification of Disorders
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American Psychiatric Association
Diagnostic and Statistical Manual of Mental Disorders
– 4th ed. (DSM-4, DSM-IV)
Five Axes
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Axis I – Clinical Syndromes
Axis II – Personality Disorders or Mental
Retardation
Axis III – General Medical Conditions
Axis IV – Psychosocial and Environmental
Problems
Axis V – Global Assessment of Functioning
Axis I Clinical Syndromes
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Anxiety Disorders-excessive apprehension
Somatoform Disorders-physical / psychological
Dissociative Disorders-multiple personalities
Mood Disorders-emotional disturbances
Schizophrenic Disorders-delusions, disorganized
speech, hallucinations
Clinical Syndromes: Anxiety Disorders
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Generalized anxiety disorder
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Phobic disorder
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“free-floating anxiety”
Specific focus of persistent, irrational fear
Panic disorder and agoraphobia
Obsessive compulsive disorder
Obsessions
 Compulsions
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Posttraumatic Stress Disorder
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attributed to experience of a major traumatic event
Etiology of Anxiety Disorders
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Biological factors
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Conditioning and learning
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Judgments of perceived threat
Over interpreting harmless situations
Personality
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Acquired through classical conditioning or
observational learning
Maintained through operant conditioning
Cognitive factors
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Genetic predisposition GABA synapse
Serotonin synapses implicated in panic/OCD
Neuroticism trait linked
Stress—a precipitator
Clinical Syndromes: Somatoform
Disorders
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Somatization Disorder- Are physical ailments that cannot be
explained by organic conditions. They are not psychosomatic diseases, which
are real physical ailments caused in part by psychological factors. They occur
mostly in women and often coexist with depression and anxiety disorders.
 Conversion Disorder- is characterized by a significant loss of
physical function (with no apparent organic basis), usually in a single organ
system(vision)
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Hypochondriasis- excessive preoccupation with health concerns
 Etiology
Reactive autonomic nervous system
 Personality factors
 Cognitive factors
 The sick role
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Figure 14.10 Glove anesthesia
Inconsistent with the known facts of physiology
Clinical Syndromes: Dissociative Disorders
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Dissociative amnesia-people lose contact with portions of their
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Dissociative fugue-loss of memory, entire lives, sense of personal
consciousness or memory, resulting in disruptions in their sense of identity. A sudden
loss of memory for important personal information that is too extensive to be due to
normal forgetting. Memory loss may be for a single traumatic event or for an
extended time period around the event.
identity
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Dissociative identity disorder-multiple personality
disorder
 Etiology
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severe emotional trauma during childhood
Controversy
25% of American psychiatrists accept scientific validity
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Media creation?
Clinical Syndromes: Mood Disorders
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Major depressive disorder-marked by profound sadness,
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Etiology
slowed thought processes, low self-esteem, and loss of interest in
previous sources of pleasure. Unipolar.
 Dysthymic disorder- chronic depression that is insufficient in
severity to justify diagnosis of major depression
 Bipolar disorder- characterized by the experience of one or
more manic episodes usually accompanied by periods of depression.
 Cyclothymic disorder-chronic but relatively mild symptoms of
bipolar disturbance
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Genetic vulnerability- predispositions
Neurochemical factors- norepinephrine and serotonin synapses
Cognitive factors- negative thinking, learned helplessness
Interpersonal roots- poor social skills, frequent rejection
Precipitating stress
Clinical Syndromes: Schizophrenia
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General symptoms
Delusions and irrational thought
 Deterioration of adaptive behavior
 Hallucinations
 Disturbed emotions
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Prognostic factors
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A more favorable prognosis exists when the onset of the disorder is sudden
and at a later age, the individual’s social and work adjustment was good
prior to onset, the proportion of negative symptoms is low, and the patient
has a good social support system.
Subtyping of Schizophrenia
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4 subtypes
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Paranoid type- delusions of persecution, grandeur
Catatonic type- striking motor disturbances, muscular rigidity
to random motor activity.
Disorganized type- severe deterioration of adaptive behavior,
incoherence, complete social withdrawal, delusions centering on
bodily functions.
Undifferentiated type- cannot be placed in any of the above
subtypes
Critics want new model for classification
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Positive symptoms: behavioral excesses or peculiarities such as
hallucinations, and delusions
Negative symptoms: behavioral deficits, such as flattened
emotions, social withdrawal and apathy
Etiology of Schizophrenia
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Genetic vulnerability
Neurochemical factors
Structural abnormalities of the brain
The neurodevelopmental hypothesis
Expressed emotion
Precipitating stress
Figure 14.18 The dopamine hypothesis as an explanation for schizophrenia
Figure 14.20 The neurodevelopmental hypothesis of schizophrenia
Personality Disorders
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Anxious-fearful cluster
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Dramatic-impulsive cluster
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Histrionic, narcissistic, borderline, antisocial
Odd-eccentric cluster
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Avoidant, dependent, obsessive-compulsive
Schizoid, schizotypal, paranoid
Etiology
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Genetic predispositions, inadequate socialization
in dysfunctional families
Table 14.2 Personality Disorders
Psychological Disorders and the Law
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Insanity- Insanity is not a diagnosis, it is a legal concept.
Insanity is a legal status indicating that a person cannot be held
responsible for his or her actions because of mental illness.
 M’naghten rule- holds that insanity exists when a mental
disorder makes a person unable to distinguish right from
wrong.
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Involuntary commitment
danger to self
 danger to others
 in need of treatment
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Figure 14.22 The insanity defense: public perceptions and actual realities