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Chapter 15
Psychological Disorders
© 2011 The McGraw-Hill Companies, Inc.
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Defining/Explaining Abnormal Behavior
Anxiety Disorders
Mood Disorders
Dissociative Disorders
Schizophrenia
Personality Disorders
Psychological Disorders and Health and
Wellness
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Abnormal Behavior
Behavior that is…
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deviant (atypical)
maladaptive (dysfunctional)
personally distressing (despair)
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Theoretical Approaches
Biological Approach: Medical Model
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disorders with biological origins
Psychological Approach
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experiences, thoughts, emotions, personality
Sociocultural Approach
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social context
Biopsychosocial Model
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interaction of biological, psychological and
sociocultural factors
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DSM-IV Classification System
Advantages
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provides a common basis for communication
helps clinicians make predictions
naming the disorder can provide comfort
Disadvantages
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stigma (shame, negative reputation)
medical terminology implies internal cause
focus on weaknesses ignores strengths
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DSM-IV-TR Axes
Multiaxial System
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Axis I and II: Psychological Disorders
Axis III: General Medical Conditions
Axis IV: Psychosocial/Environmental Problems
Axis V: Current Level of Functioning
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DSM-IV-TR Axes
Multiaxial System
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Axis I: 312.9 Disruptive Behavior Disorder
305.20 Cannabis Abuse
Axis II: V71.09 No Diagnosis
Axis III: Asthma, Diabetes
Axis IV: Ecomonic, Education, Single mx
Axis V: 51
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Global Assessment of Functioning
100-91 No symptoms
90-81
Absent or minimal symptoms (e.g., mild anxiety)
80-71
Expectable symptoms, slight impairment
70-61
Some mild symptoms/mild difficulty functioning
60-51
Moderate symptoms/moderate difficulty functioning
50-41
Serious impairment in functioning
40-31
Some impairment in reality testing/major impairment in many
areas
30-21
Inability to function in most areas, hallucinations, delusions
20-11
Some danger of hurting self, impairment in communication
10-1
Persistent danger of hurting self, inability to function
0
Inadequate information
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Anxiety Disorders
…uncontrollable fears that are
disproportionate and disruptive
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generalized anxiety disorder
panic disorder
phobic disorder
obsessive-compulsive disorder
post-traumatic stress disorder
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Generalized Anxiety Disorder
Diagnosis and Symptoms
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persistent anxiety for at least 6 months
inability to specify reasons for the anxiety
Etiology
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biological factors
- genetic predisposition, GABA deficiency, respiration
psychological and sociocultural factors
- harsh self-standards, critical parents, negative
thoughts, trauma
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Panic Disorder
Diagnosis and Symptoms
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recurrent, sudden onsets of intense terror that
often occur without warning
Etiology
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biological factors: genetic predisposition
psychological factors: misinterpret arousal
sociocultural factors: gender differences
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Phobic Disorder
Diagnosis and Symptoms
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an irrational, overwhelming, persistent
fear of a particular object or situation
(e.g., social phobia)
Etiology
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biological factors: genetic disposition
psychological factors: learned
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Examples of Phobic Disorders
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Social Phobias in the U.S.
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Obsessive-Compulsive Disorder
Diagnosis and Symptoms
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persistent anxiety-provoking thoughts and/or
urges to perform repetitive, ritualistic
behaviors to prevent or produce a situation
Etiology
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biological factors: genetic predisposition
psychological factors: life stress
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Post-Traumatic
Stress Disorder
Diagnosis and Symptoms
Symptoms develop as a result of exposure to a
traumatic event, oppressive situation, natural or
unnatural disasters
- flashbacks
- constricted ability to feel emotions
- excessive arousal
- difficulties with memory and concentration
- feelings of apprehension
- impulsive outbursts
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Post-Traumatic
Stress Disorder
Etiology
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trauma
- combat and war-related
- sexual abuse and assault
- natural and unnatural disasters
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vulnerability
- previous history of trauma
- genetic predispositions
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Mood Disorders
…disturbance of mood that affects entire
emotional state
Symptoms may include
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cognitive, behavioral, or physical symptoms
interpersonal difficulties
Types
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major depressive disorder, dysthymic disorder
bipolar disorder
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Major Depressive Disorder (MDD)
Diagnosis and Symptoms
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significant depressive episode that lasts for
at least two weeks
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defined by presence of at least 5 out of 9
symptoms
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daily functioning is impaired
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Dysthymic Disorder (DD)
Diagnosis and Symptoms
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chronic depression
- unbroken depressed mood lasting at least two
years (adult) or one year (child)
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fewer symptoms than MDD
- defined by presence of 2 out of 6 symptoms
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Major Depressive Disorder (MDD)
Etiology
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biological factors: genetic disposition
- underactive prefrontal cortex
- regulation of neurotransmitters
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psychological factors:
- learned helplessness
- ruminating on negative, self-defeating thoughts
- pessimistic attribution
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sociocultural factors
- poverty
- gender differences
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Bipolar Disorder
Characterized by extreme mood swings
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Bipolar I and Bipolar II
Frequency and separation of episodes
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usually separated by 6 months to a year
Etiology
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strong genetic component
swings in metabolic activity in cerebral cortex
levels of neurotransmitters
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Suicide
Prevalence
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over 32,000 in year 2004
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one completion for every 8 to 25 attempts
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3rd leading cause of death in early adolescence
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Suicide
Biological factors
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low levels of serotonin
poor health
Psychological Factors
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mental disorders
trauma (recent/immediate and highly stressful)
substance abuse
Sociocultural Factors
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chronic economic hardship
cultural and religious norms
gender differences
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When Someone is Threatening Suicide
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Dissociative Disorders
…sudden loss of memory or change in identity
Dissociation
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protection from extreme stress or shock
problems integrating emotional memories
Types
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dissociative amnesia
dissociative fugue
dissociative identity disorder (DID)
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Dissociative Disorders
Dissociative Amnesia
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individuals experience extreme memory
loss caused by extensive psychological
stress
Dissociative Fugue
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individuals experience amnesia,
unexpectedly travel away, and sometimes
assume a new identity
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Dissociative Identity Disorder
Diagnosis and Symptoms
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the same individual possesses two or more distinct personalities
each personality has unique memories, behaviors, and
relationships
only one personality is dominant at a time
personality shifts occur under distress
Etiology
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extraordinarily severe abuse in early childhood
social contagion
mostly women
runs in families
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Schizophrenia
highly disordered thought
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split from reality (psychotic)
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typically diagnosed in early adulthood
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high suicide risk
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Symptoms of Schizophrenia
Positive Symptoms
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hallucinations and delusions
thought disorders and disorders of movement
Negative Symptoms
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flat affect
Cognitive Symptoms
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attention difficulties and memory problems
impaired ability to interpret information and
make decisions
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Etiology of Schizophrenia
Biological Factors
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genetic predisposition
structural brain abnormalities
regulation of neurotransmitters
Psychological Factors
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diathesis-stress model
Sociocultural Factors
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influence how disorder progresses
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Personality Disorders
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Cluster A
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Paranoid, Schizoid, and Schizotypal
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Cluster B
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Antisocial, Borderline, Histrionic, and Narcissistic
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odd and eccentric
dramatic, emotional, or erratic
Cluster C
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Avoidant, Dependent, and Obsessive-Compulsive
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anxious or fearful
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Personality Disorders
…chronic maladaptive cognitive-behavioral patterns
Antisocial Personality Disorder
Diagnosis and Symptoms
- guiltless lawbreaking, violence, deceit
- impulsive, irritable, reckless, irresponsible
Etiology
- biological factors (genetic, brain, and ANS differences)
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Personality Disorders
Borderline Personality Disorder
Diagnosis and Symptoms
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instability in interpersonal relationships & self-image
impulsive, insecure, unstable & extreme emotions
Etiology
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genetic
childhood abuse
irrational belief one is powerless, unacceptable, and that
others are hostile
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Psychological Disorders and
Health and Wellness
Stereotypes and Stigma
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Rosenhan’s study - fake psychiatric patients
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negative attitudes toward mentally ill
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physical health risk
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successfully functioning individuals with mental
illness reluctant to “come out”
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Chapter Summary
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Discuss the characteristics, explanations, and
classifications of abnormal behavior.
Distinguish among the various anxiety disorders.
Compare the mood disorders and specify risk
factors for depression and suicide.
Describe the dissociative disorders.
Characterize schizophrenia.
Identify behavior patterns typical of personality
disorders.
Explain the impact of the stigma associated with
mental illness.
© 2011 The McGraw-Hill Companies, Inc.
Chapter Summary
Abnormal Behavior
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deviant, maladaptive, or personally distressing
Theoretical Approaches
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biological, psychological, and sociocultural
biopsychosocial
Classifying Abnormal Behavior
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DSM-IV-TR Axes
advantages and disadvantages
© 2011 The McGraw-Hill Companies, Inc.
Chapter Summary
Anxiety Disorders
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generalized anxiety disorder
panic disorder
phobic disorder
obsessive-compulsive disorder
post-traumatic stress disorder
© 2011 The McGraw-Hill Companies, Inc.
Chapter Summary
Mood Disorders
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major depressive disorder
dysthymic disorder
bipolar disorder
suicide
Dissociative Disorders
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dissociative amnesia
dissociative fugue
dissociative identity disorder
© 2011 The McGraw-Hill Companies, Inc.
Chapter Summary
Schizophrenia
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positive, negative and cognitive symptoms
etiology (biological, psychological, sociocultural)
Personality Disorders
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antisocial personality disorder
borderline personality disorder
Psychological Disorders and Health & Wellness
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stigmas and stereotypes
© 2011 The McGraw-Hill Companies, Inc.