Download The World: Psychology

Psychological Disorders
K. T. Hinkle
Chapter 15
Diagnostic and Statistical Manual
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Axis I: Primary clinical problem
Axis II: Personality disorders
Axis III: General medical conditions
Axis IV: Social and environmental
stressors
Axis V: Global assessment of overall
functioning
DSM-IV Example Diagnosis
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Axis I
296.23 Major Depression Disorder,
Single Episode, Severe Without
Psychotic Features
305 Alcohol Abuse
Axis II 301.6 Dependent Personality
Disorder
Axis III none
Axis IV Threat of job loss
Axis V
GAF=35 (current)
DSM-IV Example Diagnosis
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Axis I
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Axis II
Axis III
Axis IV
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Axis V
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312.82 Conduct Disorder,
Adolescent-Onset Type
305.20 Cannabis Abused
V62.3 Academic Problem
317 Mild Mental Retardation
345.00 Epilepsy, petit mal
Problems related to
interaction with the legal
system
GAF=55 (on admission)
GAF=65 (at discharge)
Explosion of Mental Disorders
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Supporters of new
categories answer
that is important to
distinguish disorders
precisely.
Critics point to an
economic reason:
diagnoses are
needed for
insurance reasons so
therapists will be
compensated.
What Is Abnormal?
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Defining mental disorders
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Several questions can help determine what behavior
is abnormal:
 Is the behavior considered strange within the
person’s own culture?
 Does the behavior cause personal distress?
 Is the behavior maladaptive?
 Is the person a danger to self of others?
 Is the person legally responsible for his or her
acts?
What Is Abnormal?
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Prevalence of psychological disorders
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Mental disorders have a lifetime prevalence rate of
nearly 50%
Mental disorders represent a significant source of
personal misery for individuals and lost productivity
for society
Explaining psychological disorders
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Biological perspective
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Views abnormal behavior as arising from a physical cause,
such as genetic inheritance, biochemical abnormalities or
imbalances, structural abnormalities within the brain,
and/or infections
What Is Abnormal?
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Explaining psychological disorders (continued)
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Biopsychosocial perspective
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Agrees that physical causes are of central importance but
also recognizes the influence of biological, psychological,
and social factors in the study, identification, and treatment
of psychological disorders
Psychodynamic perspective
Originally proposed by Freud
Maintains that psychological disorders stem from early
childhood experiences and unresolved, unconscious
conflicts, usually of a sexual or aggressive nature
What Is Abnormal?
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Explaining psychological disorders
(continued)
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Learning perspective
 Psychological disorders are thought to be learned
and sustained in the same way as any other
behavior
Cognitive perspective
 Suggests that faulty thinking or distorted
perceptions can contribute to some types of
psychological disorders
Anxiety Disorders
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Generalized anxiety disorder
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An anxiety disorder in which people experience
excessive anxiety or worry that they find difficult to
control
This disorder affects twice as many women as men
and leads to considerable distress and impairment
Panic disorder
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An anxiety disorder in which a person experiences
recurrent unpredictable attacks of overwhelming
anxiety, fear, or terror
Panic attacks
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An attack of overwhelming anxiety, fear, or terror
Anxiety Disorders
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Phobias
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An intense fear of being in a situation from which
immediate escape is not possible or in which help is
not immediately available in case of incapacitating
anxiety
Agoraphobia
An agoraphobic often will not leave home unless
accompanied by a friend or family member and,
in severe cases, not even then
 Women are four times more likely than men to
be diagnosed with agoraphobia
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Anxiety Disorders
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Phobias (continued)
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Social phobia
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An irrational fear and avoidance of social situations in
which one might embarrass or humiliate oneself by
appearing clumsy, foolish, or incompetent
Specific phobia
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A marked fear of a specific object or situation
A person has three times the risk of developing a phobia if
a close relative suffers from one
Anxiety Disorders
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Obsessive compulsive disorder (OCD)
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An anxiety disorder in which a person suffers from
obsessions and/or compulsions
Obsessions
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A persistent, recurring, involuntary thought, image, or
impulse that invades consciousness and causes great
distress
Compulsion
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A persistent, irresistible, irrational urge to perform an act
or ritual repeatedly
Mood Disorders
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Disorders characterized by extreme and
unwarranted disturbances in feeling or
mood
Depressive disorders
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Major depressive disorder
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A mood disorder marked by feelings of great
sadness, despair, guilt, worthlessness, and
hopelessness
Mood Disorders
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Bipolar disorder
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A mood disorder in which manic episodes alternate
with periods of depression, usually with relatively
normal periods in between
Manic episode
 A period of extreme elation, euphoria, and
hyperactivity, often accompanied by delusions of
grandeur and by hostility if activity is blocked
Bipolar disorder is much less common than major
depressive disorder
Mood Disorders
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Causes of mood disorders
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Biological factors such as genetic inheritance and
abnormal brain chemistry play a major role in
bipolar disorder and major depressive disorder
In one twin study, researchers found that 50% of
the identical twins of bipolar sufferers had also been
diagnosed with a mood disorder, compared to only
7% of fraternal twins
Mood Disorders
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Suicide and race, gender, and age
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Whites are more likely to commit suicide than
African Americans
Native American suicide rates are similar to those of
whites; rates for Hispanic Americans are similar to
those of African Americans
Suicide rates are far lower for both white and
African American women than for men
Older Americans are at far greater risk for suicide
than younger people
Schizophrenia
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A severe psychological disorder characterized
by loss of contact with reality, hallucinations,
delusions, inappropriate or flat affect, some
disturbance in thinking, social withdrawal,
and/or other bizarre behavior
Positive symptoms of schizophrenia
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Positive symptoms are the abnormal behaviors that
are present in people with schizophrenia
Hallucinations
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A sensory perception in the absence of any external
sensory stimulus; an imaginary sensation
Schizophrenia
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Delusions
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Delusions of grandeur
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A false belief, not generally shared by others in
the culture, that cannot be changed despite
strong evidence to the contrary
A false belief that one is a famous person or a
person who has some great knowledge, ability,
or authority
Delusions of persecution
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A false belief that a person or group is trying in
some way to harm one
Schizophrenia
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Types of schizophrenia
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Paranoid schizophrenia
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A type of schizophrenia characterized by delusions of
grandeur or persecution
Paranoid schizophrenics often show exaggerated anger and
suspiciousness
Disorganized schizophrenia
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The most serious type of schizophrenia, marked by
inappropriate affect, silliness, laughter, grotesque
mannerisms, and bizarre behavior
Tends to occur at an earlier age than the other types
Schizophrenia
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Types of schizophrenia (continued)
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Catatonic schizophrenia
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A type of schizophrenia characterized by complete stillness
or stupor and/or periods of great agitation and excitement;
patients may assume an unusual posture and remain in it
for long periods
Undifferentiated Schizophrenia
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A term for people who display symptoms of schizophrenia
but who do not fit into other categories
Schizophrenia
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Risk factors in schizophrenia
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Schizophrenia develops when there is both a genetic
predisposition toward the disorder and more stress
than a person can handle
Schizophrenia is more likely to strike men than
women
The earlier age of onset of the disorder among
males appears to be independent of culture and
socioeconomic variables
Somatoform and Dissociative
Disorders
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Somatoform disorders
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Disorders in which physical symptoms are present
that are due to psychological rather than physical
causes
Hypochondriasis
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A somatoform disorder in which persons are preoccupied
with their health and convinced they have some serious
disorder despite reassurance from doctors to the contrary
Conversion disorder
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A somatoform disorder in which a person suffers a loss of
motor or sensory functioning in some part of the body
(blind, deaf, or unable to speak)
Somatoform and Dissociative
Disorders
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Dissociative disorders
A disorder in which, under stress, one loses the
integration of consciousness, identity, and
memories of important personal events
 Dissociative amnesia
 A dissociative disorder in which there is a loss of
memory of limited periods in one’s life or of one’s
entire identity
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Somatoform and Dissociative
Disorders
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Dissociative disorders (continued)
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Dissociative fugue
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A dissociative disorder in which one has a
complete loss of memory of one’s entire identity,
travels away from home, and may assume a new
identity
Dissociative identity disorder (DID)
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A dissociative disorder in which two or more
distinct personalities occur in the same person,
each taking over at different times; also called
multiple personality
Somatoform and Dissociative
Disorders
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Dissociative disorders (continued)
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Dissociative identity disorder (continued)
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The alternate personalities may differ radically in
intelligence, speech, accent, vocabulary, posture, body
language, hairstyle, taste in clothes, manners, and even
handwriting and sexual orientation
There is the common complaint of “lost time”—periods for
which a given personality has no memory because he or
she was not in control of the body
Other Psychological Disorders
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Sexual disorders
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Disorders that are destructive, guilt- or
anxiety-producing, compulsive, or that cause
discomfort or harm to one or both parties
involved
Perhaps the most common of all of the
sexual disorders are the sexual dysfunctions
Drug treatment for sexual dysfunctions in
both men and women have proven
successful
Other Psychological Disorders
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Sexual disorders (continued)
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Paraphilias
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Disorders in which recurrent sexual urges, fantasies, and
behaviors involve nonhuman objects, children, other
nonconsenting persons, or the suffering or humiliation of
the individual or his/her partner
Gender Identity Disorders
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Disorders characterized by a problem accepting one’s
identity as male or female
An individual may feel so strongly that she or he is
psychologically of the other gender that sex-reassignment
surgery is sought
Other Psychological Disorders
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Personality disorders
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A continuing, inflexible, maladaptive pattern of inner
experience and behavior that causes great distress
or impaired functioning and differs significantly from
the patterns expected in the person’s culture
Characteristics of personality disorders
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People who suffer from other disorders, especially the
mood disorders, are often diagnosed with personality
disorders as well
People with personality disorders are extremely difficult to
get along with