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XII. Psychological Disorders
A. Who is mentally ill?
What is “disordered” behavior?
Psychological disorder: typically includes constellation of
cognitive, emotional, and behavioral symptoms that create
significant stress (impair work, relationships, etc.)
1. Characteristics of disordered behavior.
– Atypical, but...
– Disturbing, but particularly worrisome when ...
– Maladaptive
– Unjustifiable
– Involuntary
A. Who is mentally ill?
What is “disordered” behavior?
2. Diagnosing disordered behavior.
230 possible diagnoses.
a. Development of the DSM
(Diagnostic and Statistical Manual for Mental Disorders)
First edition 1952: too subjective.
Third edition 1980: created objective criteria.
Today - Fourth Edition
- How it is used
Important today for insurance.
A. Who is mentally ill?
What is “disordered” behavior?
ii. The DSM and labeling.
- Can giving people a label be problematic?
- Rosenhan et al., (1973)
- Stigma associated with mental illness.
B. Why are people mentally ill?
1. Historically (1600-1700’s):
Supernatural, witch craft.
Bleeding, magic, drill holes in skull
Institutions like zoos
B. Why are people mentally ill?
2. Medical Model
In reaction to maltreatment.
First scientific approach to disorders.
Psychological disorders are caused by physical
conditions that can be cured.
(disease not depravity).
B. Why are people mentally ill?
3. Bio-Psycho-Social Perspective
- More contemporary.
- Considers more influences.
Biological (genes, brain chemistry)
Environment (stress, roles, expectations)
- Reflects the nature/nurture perspective.
C. Anxiety Disorders
1. General Description
experience extreme/intense fear, panic, anxiety
most treatable, best prognosis
2. Generalized Anxiety Disorder
Unfocused, free-floating anxiety
5% of N. Americans experience disorder at some point in life.
**Must occur for more days than not for 6 month period.
C. Anxiety Disorders
2. Generalized Anxiety Disorder
Genetic predisposition
Hyper-vigilance/Over-arousal in brain
Can lead to panic attacks, panic disorder.
C. Anxiety Disorders
3. Phobias
- Focus anxiety on specific source.
- Examples…
- Causes: Learning approach:
Classical conditioning
Observational learning
Genetic (amygdala)
C. Anxiety Disorders
4. Obsessive Compulsive Disorder
- Trapped in endless cycle of repetitive thoughts
(obsessions) and actions (compulsions).
- Possibly 4 million people have OCD at one time
in life.
- Examples...
C. Anxiety Disorders
Severe, prolonged, disrupts normal living
Consumes more than one hour a day.
Causes similar to generalized anxiety.
Post-Traumatic Stress Disorder – see text.
D. Dissociative Disorders
1. General Description
- Most controversial of disorders.
- Experience sudden loss of memory or change
- “Dissociate” in response to stressful event.
D. Dissociative Disorders
2. Dissociative Amnesia
- Selective memory loss in response to
intolerable psychological stress.
- Cannot remember distant/recent past
name, identity
D. Dissociative Disorders
3. Dissociative Fugue
- Flight from one’s home and identity
accompanies memory loss.
(take on complete new identity in different
D. Dissociative Disorders
4. Dissociative Identity Disorder
- Previously called multiple personality.
- People have two or more distinct personalities
that alternately control behavior.
- Why is this disorder so controversial?
D. Dissociative Disorders
- natural, protective response
- often women who were abused as kids
- may be encouraged by inborn, biological capacity
Or - contrived fantasy?
Or - created by therapist?
E. Schizophrenia
1. General Description and Symptoms.
- Accounts for higher % of patient population in mental
hospitals than any other disorder.
E. Schizophrenia
1. Symptoms:
Disorganized Thinking: no organization, fragmented,
includes delusions.
Disturbed Perceptions: perceive things that aren’t
there, hallucinations.
(typically auditory “hear voices”)
Inappropriate Emotions & Actions: Strike out, cry
when should laugh, flat affect, movement - rocking,
rubbing, motionless
E. Schizophrenia
2. Types of Schizophrenia
Positive - disorganized, deluded, acting out
Negative - mute, catatonic, expressionless
Chronic or Process - develops gradually, long
history, recovery doubtful.
Acute or Reactive - develops in reaction to life
stress, recovery more likely.
E. Schizophrenia
Many genes involved
Excess number of dopamine receptors.
Abnormal brain tissue.
Low brain activity in frontal lobes.
Environment?: need to have predisposition.
F. Mood Disorders
 Prolonged emotional state that colors many (or
all) aspects of thoughts & behavior.
 Spans from severe sad/bad (depression) to
unbridled elation, happiness (mania).
- Number one reason people seek mental health
F. Mood Disorders
1. Depression
focused on negative
absence of pleasure, hopelessness
self-blame, worthlessness
affects sleep, speech, movement, eating
F. Mood Disorders
1. Major Depressive Disorder
- 2 levels:
Dysthymic Disorder - sad mood, low energy,
difficulty concentrating.
Major Depressive Disorder - more disabling,
possibly with suicidal thoughts.
F. Mood Disorders
1. Major Depressive Disorder
 Causes
- Brain: neurotransmitters
- Genetic: twin studies
F. Mood Disorders
1. Major Depressive Disorder
 Causes:
- Socio-Cognitive Perspective
Influence of interpreting events & coping.
Attribution process for negative events:
internal, stable, global
Ruminate, develop hopelessness and learned
F. Mood Disorders
2. Bipolar Disorder
- Was manic depressive disorder.
- Alternate between hopelessness (dep) and
overexcitedness (mania).
overtalkative, easily irritated, little need for
sleep, loud speech, high opinion of self,
reckless, fewer sexual inhibitions
F. Mood Disorders
2. Bipolar Disorder
- genetic: 7 in 10 chance for twins.
- brain: neurotransmitters abundant during
- environmental influence unclear.
Disorders – rates are increasing
1 in 6 Americans
Symptoms by age 24
G. Personality Disorders – see text
Inflexible and enduring patterns of behavior
that impair one’s social functioning.
1. Histrionic: shallow, attention-getting
2. Narcissistic: unwarranted sense of selfimportance, cannot accept criticism, demand
for constant attention.
G. Personality Disorders
3. Antisocial: socio or psychopath.
Typically male, lack of conscience.
Lie, steal, fight, unrestrained sexual behavior,
fear and feel for few, no guilt.
4. Borderline: unstable identity, relationships,
and emotions.
C. Anxiety Disorders
5. Posttraumatic Stress Disorder – see text
- Only anxiety disorder directly tied to
experiencing or witnessing traumatic event(s).
- Symptoms:
nightmares, reliving events
sleeplessness, irritability, guilt
emotional numbing, depression
- Importance of social support/genetics.