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Chapter 16 – Psychological Disorders
Watch “What About Bob”
“What About Bob” Worksheet
Section 1 – What are Psychological Disorders
Pre-Assessment
Read “Normal or Not?”
1. Some behavior people see as normal while others see the same behavior as
abnormal
a. Insanity has been defined as doing the same thing over and over,
expecting a different result
b. The term insane is not used much more in the medical profession,
replaced with psychopathology
2. Deviation from Normality
a. Any deviation from the average or majority
b. Different cultural norms must be taken into consideration
i. Because the majority isn’t always right or best, this deviance
approach is not in itself a useful standard
3. Adjustment
a. Normal people are able to get along socially, physically and
emotionally in the world
b. Can feed and clothe themselves
c. Abnormal people fail to adjust in these ways
d. But, behavior in one society may not be acceptable in other societies
4. Psychological Health
a. Self-Actualization – Humanistic view that to be normal or healthy
involves full acceptance and expression of one’s own individuality and
humanness
i. Problem with this approach is that its hard to determine
whether a person is actualizing themselves
b. Labeling a person as mentally ill because of their odd behavior is a
mistake as well as cruel and irresponsible
c. Many of these people just have problems in living that causes conflicts
d. It is only when a psychological problem becomes severe enough to
disrupt everyday life that it is thought of as an abnormality or illness
5. The Problem of Classification
a. DSM – The Diagnostic and Statistical Manual of Mental Disorders
i. Currently in its 4th revision
ii. A classification manual that show such things as
1. Features
2. Diagnosis
3. 5 Axis
Section 1 Review
Section 2 – Anxiety Disorders
1. Anxiety – a general state of dread or uneasiness that a person feels in response
to a real or imagined danger
a. Feeling anxiety out of proportion to the situation provoking it
b. Affects 19 million Americans annually
c. Characteristics:
i. Feelings of anxiety
ii. Personal inadequacy
iii. Avoidance of dealing with problems
iv. Unrealistic images of themselves
v. Unable to free themselves of recurring fears and worries
d. Expressed through:
i. Constant worrying
ii. Sudden mood swings
iii. Physical symptoms
1. headaches
2. sweating
3. muscle tightness
4. weakness
5. fatigue
e. Anxious people often have difficulty forming stable and satisfying
relationships
2. General Anxiety Disorder
a. Feeling nervous for reasons they can’t explain
b. Can become full blown panic attacks
i. Choking sensation
ii. Chest pain
iii. Dizziness
iv. Trembling
v. Hot flashes
c. They neglect social relationships
d. Trouble dealing with friends, family or responsibilities
e. The more they worry the more difficulty they have, the more difficulty
they have the more they worry – a vicious cycle
f. Physical symptoms attached include: poor appetite, frequent urination,
indigestion and diarrhea
g. Causes:
i. Learned anxiety
ii. Inherited
iii. Environmental factors
iv. Uncertainties of modern life
3. Phobic Disorder (phobia)
a. Phobia/Phobic Disorder – when severe anxiety is focused on a
particular object, animal, activity or situation that seems out of
proportion to the real danger involved
b. Develop elaborate plans to avoid those situations
c. Can range from mild to severe
d. Treatment
i. Providing the person a experience their phobia under
conditions where they feel safe
4. Panic Disorder
a. Panic – a feeling of sudden, helpless terror
b. During a panic attack, the person experiences sudden, unexplainable,
attacks of intense anxiety, leaving them fearing death and doom
c. Physical Symptoms:
i. Sense of smothering
ii. Choking
iii. Difficulty breathing
iv. Faintness or dizziness
v. Nausea
vi. Chest pains
d. Can last minutes or hours and occur without warning
e. Causes:
i. Inherited
ii. Environment
1. interpreting a physiological arousal (higher heart rate)
as disastrous
5. Obsessive-Compulsive Disorder
a. Obsession – an uncontrollable pattern of thoughts
b. Compulsion – repeatedly performing coping behaviors
c. Obsessive-Compulsive Disorder – experiencing both together
i. Everyone has obsessions and compulsions
ii. Problem when it interferes with what a person wants and needs
to do
iii. Causes:
1. Serve as diversions from a person’s real fears and their
origins and may reduce anxiety
2. May run in families, genetic
3. Most people with the disorder know that their thoughts
and actions are irrational, but they feel unable to stop
them
6. Post-Traumatic Stress Disorder
a. PTSD – a person who has experienced a traumatic event feels severe
and long lasting aftereffects
b. Those who suffer include:
i. Veterans of wars
ii. Survivors of terrorist attacks
iii. Natural disaster victims: hurricanes, tornadoes
c.
d.
e.
f.
g.
iv. Plane crashes
v. Assault and rape victims
The event that triggers the disorder overwhelms a person’s sense of
reality and ability to cope
Can begin immediately after the event or later in life
Symptoms
i. Flashbacks
ii. Nightmares
Can be long lasting
People exposed to events repeatedly or over a long period of time are
more likely to develop the condition
Section 2 Review
Section 3 – Somatoform and Dissociative Disorders
1. Somatoform Disorders – when anxiety creates a variety of physical symptoms
for which no physical cause is apparent
a. Also known as hysteria – unexplainable fainting, paralysis or deafness,
used in Freud’s time
b. Conversion Disorders
i. Conversion Disorder – the conversion of emotional difficulties
into the loss of a specific physiological function
1. No actual physical damage is present
ii. When someone is frightened and they can’t move (common),
uncommon for it to persist
iii. Results in a real and prolonged handicap
iv. If a person wakes up paralyzed from the waist down and accepts it
with calmness (la belle indifference), its known to be a
psychological problem
v. Psychologists believe that people suffer from conversion disorders
to gain freedom from unbearable conflict
vi. Very Rare!!
c. Hypochondriasis
i. A person in good health who becomes preoccupied with imaginary
ailments
ii. Hypochondriacs spend time looking for signs of serious illness and
misinterprets minor aches, pains and bruises as early signs of fatal
illness
1. Regardless of medical tests and diagnosis, they will
continue to believe it
2. Occurs during young adulthood
3. Occurs when an individual represses emotions and then
expresses them symbolically in physical symptoms
2. Dissociative Disorders – when a person experiences alterations in memory,
identity or consciousness
a. Can be normal, daydreaming and not hearing your name being called
b. Amnesia and multiple personality are very, very rare
c. Dissociative Amnesia
a. Memory loss that has no biological explanation
b. May be an attempt to escape from problems by blotting them out
entirely
c. Remember how to speak and retain general knowledge, but don’t
know who they are, where they are from, how they got where they
are
d. Most often results from a traumatic event – a terrible accident
d. Dissociative Fugue
a. Amnesia coupled with an active flight to a different environment
b. Person disappears and then wakes up the next day long ways from
home
c. If not treated, they establish a new identity in the new place
d. Represses all knowledge of a previous life
e. May last for days or years
f. When they re-emerge, they have no memory of what had happened
g. Escape from unbearable conflict or anxiety
e. Dissociative Identity Disorder (multiple personality disorder)
a. A person exhibits two or more personality states, each with its own
behavior and thinking patterns
b. Different states may take controls at different times
c. Famous Case – Eve White
i. Treatment for severe headaches and blackouts,
conscientious, self-controlled, and shy
ii. During one treatment, her expression and personality
suddenly changed, became Eve Black
iii. Child-like, fun-loving and irresponsible (opposite of her
other self)
iv. Eve Black was conscious of Eve White but considered her
a separate person, Eve White didn’t know about Eve Black
though nor Jane (a 3rd personality)
v. Film – The 3 Faces of Eve
vi. Went on to write a book detailing 22 identities
vii. Sybil (book and film as well) had 16 personalities
d. Psychologists believe that dividing up the personality is the
individual’s effort to escape from a part of the self that they fear
e. The secret self then emerges as a separate identity
f. EXTREMELY RARE!!! And controversial
g. People diagnosed usually suffered from severe physical,
psychological or sexual abuse during childhood
Section 3 Review
Read Case Study on Munchausen’s Syndrome and Munchausen’s Syndrome
by Proxy
Watch “A Beautiful Mind”
“A Beautiful Mind” Worksheet
Section 4 – Schizophrenia and Mood Disorders
1. People with schizophrenia often have difficulty using language to
communicate
a. They go from one phrase to another by random association
b. Schizophrenia affects the area of the working memory used to make
sentences
c. Don’t remember the beginning of the sentence so they finish it with an
unrelated thought
2. People with schizophrenia withdraw from normal life, have distorted
perceptions and whose behavior reach an irrational, fantastic, fear-laden,
unimaginable levels
3. Marshall Applewhite and 38 members of Heaven’s Gate (many other cult
leaders) commit mass suicide. Applewhite was identified as schizophrenic
a. Charles Manson (In Dispute)
b. Joan of Arc
c. Adolf Hitler
d. Jim Jones
e. Son of Sam – David Berkowitz (In Dispute)
f. Unabomber Ted Kaczynski (In Dispute)
g. Syd Barrett
h. Mary Todd Lincoln
4. What is Schizophrenia
a. Schizophrenia – involves confused and disordered thoughts and
perceptions
i. Affects 1 in 100 worldwide
ii. Thoughts are disturbed and contact is lost with reality to a
considerable extent
iii. Live life as an unreal dream
Read quote ending with “Naturally, I am growing my father’s hair.”
iv. Not a single problem, no single cause, no single cure
v. Symptoms
1. Delusions – false beliefs maintained in the face of
contrary evidence
2. Hallucinations – perceptions in the absence of
corresponding sensation
3. Incoherence – marked decline in thought process
4. Word Salad – lots of words thrown together
5. Disturbances of affect – emotions that are inappropriate
for the circumstances
6. Deterioration in normal movement – slowed movement,
nonmovement or highly agitated behavior
7. Decline in previous level of functioning – sharp drop
off in productivity of work
8. Diverted attention – as if the person is unable to focus
their attention
b. Types of Schizophrenia
i. Paranoid Type
1. Involves hallucinations and delusions
a. Grandeur – “I am the savior of my people”
b. Persecution – “Someone is always watching
me”
ii. Catatonic Type
1. Remain motionless for long periods
2. Exhibiting waxy, flexibility in which limbs in unusual
positions may take a long time to return to a resting,
relaxed position
iii. Disorganized Type
1. Incoherent language, inappropriate emotions, giggling
for no apparent reason, generally disorganized motor
behavior and hallucinations/delusions
iv. Remission Type
1. Anyone whose symptoms are gone or still exist but
aren’t severe enough to have earned a diagnosis of
schizophrenia in the first place
2. Belief is that the symptoms will return
v. Undifferentiated Type
1. Encompasses a large amount of the symptoms all in one
person
vi. Treatment
1. Very complex condition
2. Treatment is long term and usually requires
hospitalization
a. Sometimes leads to burn-out – one who is not
likely to function normally in society
3. May go into remission but adjustment tends to
deteriorate between successive episodes of the
reappearance of symptoms
4. No real cure for schizophrenia exists
c. Cause of Schizophrenia
i. Biological Influences/Genetics
1. Almost certainly involved
2. 1% of having schizophrenia, 10% if someone else in the
family has it, in twins there is a 48% chance if one has
it, the other will
3. Can’t specify the exact contribution hereditary factors
have
ii. Biochemistry and Physiology
1. Chemical imbalances in the brain
2. Too much or too little of a specific chemical in the
brain has upset the processing of information, interferes
with normal synaptic transmission (Page 157-158)
3. Dopamine Hypothesis – too much dopamine at the
selected synapses
4. Using CAT and MRI scans, shows signs of deteriorated
brain tissue
5. Exact role of the environment is fostering schizophrenia
is unclear, but it is involved
iii. Family and Interactions
1. Pathogenic, unhealthful, families may contribute to
problems in adult years, but don’t in and of themselves
lead to schizophrenia
5. Mood Disorders
a. Emotions that hamper the ability to function effectively
i. In extreme cases, a mood may cause them to lose touch with
reality or threaten their health or lives
b. Major Depressive Disorder
i. Spend at least 2 weeks feeling depressed, sad, anxious, fatigued
and agitated
1. Causes a reduced ability to function and interact with
others
2. Mild feelings of uneasiness, sadness and apathy to
intense suicidal despair
3. CAN NOT be associated with bereavement – loss of a
loved one
4. Marked by 4 symptoms
a. Problems with eating, sleeping, thinking,
concentrating and decision making
b. Lacking energy
c. Thinking about suicide
d. Feeling worthless or guilty
c. Bipolar Disorder – individuals are excessively and inappropriately
happy or unhappy
i. High elation, hopeless depression or an alternation between the
two
ii. Manic Phase
1. Elation, extreme confusion, distractibility and racing
thoughts
2. Exaggerated sense of self-esteem and engages in
irresponsible behaviors
a. Shopping sprees or insulting remarks
3. Act as though they need less sleep, activity level
increases as does the loudness and frequency with
which they speak
iii. Depressive Phase
1.
2.
3.
4.
Failure, sinfulness, worthlessness and despair
Marked by lethargy, despair and unresponsiveness
Essentially the same as the major depressive disorder
May alternate between frantic action and motionless
despair
iv. Some people have episodes separated by long intervals of
normal behavior, others have no normal behavior and just
alternate between the two
d. Seasonal Affective Disorder
i. In winter these people develop a deep depression
ii. Spirits only lift with the coming of spring
iii. Tend to sleep and eat excessively during their depressed period
iv. Cause
1. Melatonin may play a role
a. Less light (winter) more melatonin is secrete by
the pineal gland
b. High levels can cause Seasonal Affective
Disorder
2. Can be treated by sitting under bright fluorescent lights
during the evening or early morning hours
e. Explaining Mood Disorders
i. Psychological Factors
1. Personality traits (self esteem)
2. Amount of social support
3. Ability to deal with stressful situations
ii. Beck Theory
1. Depressed people draw illogical conclusions about
themselves, blame themselves for normal problems and
consider every minor failure a catastrophic event
iii. Seligman Theory
1. Caused by feeling of learned helplessness
2. Learns to believe that they have no control over events
in their lives and that it’s useless to try
f. Suicide and Depression
i. Not all people who commit suicide are depressed and not all
depressed people attempt suicide
ii. Many depressives do think about suicide though, and some
translate these thought into action
iii. People commit suicide for a number of reasons
1. Escape from physical pain
a. Terminal illness
2. Escape from emotional pain
a. Loneliness of old age
3. An effort to end the torment of unacceptable feelings
4. To punish themselves for wrongs they committed
5. To punish others
iv.
v.
vi.
vii.
viii.
ix.
x.
6. Many times there is no explanation
More than 30,000 Americans end their lives by suicide
1. 1 every 20 minutes
More women than men attempt suicide
More men than women succeed in suicide
Most common among the elderly
2nd most cause of death for college students
People who threaten or make an unsuccessful attempt are very
serious
70% of those who commit suicide have threatened to do so
within 3 months preceding the suicide
1. An unsuccessful attempt is usually a trial run
Section 4 Review
Section 5 – Personality Disorders and Drug Addiction
1. Personality Disorder
a. Generally don’t suffer from acute anxiety nor do they behave in bizarre,
incomprehensible ways
b. Unable to establish meaningful relationships with other people, to assume
social responsibilities or adapt to their social environment
c. Antisocial Personality (Sociopaths and Psychopaths)
i. Exhibit a persistent disregard for and violation of others’ rights
ii. Treat people as objects
iii. Live for the moment
iv. Seeking thrills is the major occupation
v. If they injure or hurt people along the way they feel no shame or
guilt
vi. No matter how many times they get into trouble, jailed or
punished, they never learn to stay out of trouble
vii. Usually intelligent, entertaining and fake emotions, they win
confidence and affection of others
2. Drug Addiction
a. Become a major psychological problem
b. Millions depend so heavily on drugs that they hurt themselves physically,
socially and psychologically
c. Psychological Dependence – depend so much on a drug that without it
they feel nervous and anxious, that feeling of well-being
i. Alcohol
ii. Caffeine
iii. Nicotine
iv. Cocaine
v. Marijuana
vi. Amphetamines
d. Physical Addiction – when the drug state becomes the normal body state,
without the drug there is extreme physical discomfort
i. Tolerance – developed when a person becomes so addicted to a
drug that they have to continually increase the dosage to obtain the
high that used to be achieved with lower doses
ii. Withdraw – a state of physical and psychological upset during
which the body and mind revolt against and finally gets used to the
absence of the drug
1. mild nausea
2. shakes
3. hallucinations
4. convulsions
5. coma
6. death
e. Alcoholism
i. Most serious drug addiction
ii. 10 to 12 million Americans abuse alcohol
iii. 40% of all deaths in automobile accidents and 40% of all murders,
alcohol is involved
iv. Social drug, causes one to lose some inhibition
v. Is actually a depressive
vi. Perceptions and sensations become distorted, behavior may
become obnoxious
vii. People stumble, weave, slurred speech and slow reaction times
viii. Unconsciousness, coma, death
ix. Can produce psychological dependence, tolerance and addiction
x. Can develop from both environmental and genetic factors
1. 3 to 4 times higher is a family member is an alcoholic
2. Poor home life
xi. Treatment
1. Get through delirium tremens, violent withdraw
2. Drugs and/or psychotherapy
3. Group Therapy – AA
4. Medication – Antabuse, causes a person to become
violently sick if they drink alcohol
5. No cure!!
Section 5 Review
Chapter 16 Assessment (Reviewing Vocabulary, Recalling Facts, Critical Thinking)