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Chapter 11: Psychological Disorders
Michael L. Farris
Psychology 101
What is “Normal”?
–
Normal Curve (Coon, p. 495): A bell-shaped curve with a large
number of scores in the middle, tapering to very few extremely
high and low scores (please see the illustration on page 495).
–
Situational Context (Coon, p. 495): The social situation,
behavioral setting, or general circumstances in which an action
takes place.
–
Before any behavior can be defined as abnormal, we must
consider the situational CONTEXT in which it occurs.
–
Is it normal to stand outside and water a lawn? It depends on
whether it is raining. Is it abnormal for a grown man to remove
his pants and expose himself to another man or woman in a place
of business? It depends on whether the other person is a bank
clerk or a doctor!
–
Almost any imaginable behavior can be considered normal in
some contexts, as the example on Coon, p. 495 (about the rugby
team whose airplane crashed in the Andes in 1972, forcing the
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survivors to eat the bodies of those who died in the crash. Yum!).
Cultural Relativity
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†
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Perceptions and judgments made relative
to the value of one’s culture.
Culture is one of the most influential
contexts in which any behavior is
judged.
In some cultures it is considered normal
to defecate or urinate in public or to
appear naked in public.
In our culture such behaviors would be
considered unusual or abnormal. Thus,
cultural relativity can affect the diagnosis
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of mental disorders (Coon, p. 495).
Disorders
– Mental Disorder (Nevid, Pgs. 386-387; Coon
pg. 496): A significant impairment in
psychological functioning. A list of “DSM-IV”
categories of disorders is listed on page 499, in
Table 14.4.
– Organic Mental Disorder (Coon p. 498): A
mental or emotional problem caused by
malfunction of the brain. Brain pathology
includes drug damage, diseases of the brain,
injuries, poisons, and so on (please refer to
Table 14.2 on Coon, page 497).
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Mood Disorder
Mood disorder (Nevid pages 400-403, Coon
pages 500-501): A major disturbance in mood or
emotion, such as depression or mania.
Mood disorders primarily involve disturbances in
affect, or emotion. Afflicted persons may be
manic, which means agitated, euphoric, and
hyperactive, or they may be depressed. Some
cycle between mania and depression (manic
depression, or bipolar disorder). In each case,
extremes of mood are intense or long lasting.
In addition, depressed individuals run a high risk
of suicide. Mood disorders may include
psychotic symptoms, and they are sometimes
caused by mental conditions or drug abuse. 5
Anxiety disorder (Nevid Pgs. 389393, Coon Pgs. 500-501)
–
Disruptive feelings of fear, apprehension, or anxiety, or
distortions in behavior that are anxiety related. Anxiety
disorders may take the form of panic (in which the person
suffers sudden unexplainable feelings of panic), phobias
(excessive, irrational fears), or generalized anxiety (chronic
and persistent anxiety). Other anxiety disorders are post
traumatic stress disorder (high anxiety that persists long
after an extremely distressing event, such as military
combat) and acute stress disorder (high anxiety that
occurs immediately after a highly distressing event, such
as an airliner crash).
–
A pattern known as obsessive-compulsive behavior is
also associated with anxiety.
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Somatoform and Dissociative
– Somatoform disorder (Nevid Pgs. 394, 396-397;
Coon, Pgs. 500-501): Physical symptoms that
mimic disease or injury (paralysis, blindness,
illness, or chronic pain, for example) for which
there is no identifiable physical cause. In such
cases it is assumed that psychological factors
underlie the symptoms.
– Dissociative disorder (Nevid Pgs. 394, 396-397
Coon, Pgs. 500-501): Temporary amnesia,
multiple personality, or depersonalization (feelings
of being outside one’s body, of behaving like a
robot, or of being in a dream world).
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Neurosis and Insanity
–
Neurosis (Nevid pg. 389, Coon pg. 501): An outdated term once used
to refer, as a group, to anxiety disorders, somatoform disorders,
dissociative disorders, and some forms of depression. The term
neurosis is fading from use because it tends to lump together too many
separate problems. Even so, you may sometimes hear the term
neurosis used to loosely refer to problems involving excessive anxiety.
–
Insanity (Coon, p. 501): A legal term that refers to a mental inability to
manage one’s affairs or to be aware of the consequences of one’s
actions. Persons who are declared legally insane are not legally
responsible for their actions. If necessary, they can be involuntarily
committed to a mental hospital. An example from page 501 in our text
is Mark David Chapman, who was declared insane after he killed
former Beatle John Lennon. Chapman claimed that devils forced him
to kill Lennon.
–
Legally, insanity is established by testimony from expert witnesses
(psychologists and psychiatrists). An expert witness is a person
recognized by a court of law as being qualified to give opinions on a
specific topic. In practice, those who are involuntarily committed are
usually judged to be a danger to themselves or to others, or they are
severely mentally disabled.
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Antisocial Personality
Antisocial personality (Nevid, Pgs. 410-412; Coon, Pg.
503): A person who lacks a conscience, is emotionally
shallow, impulsive, selfish, and tends to manipulate others.
Such people, who are sometimes referred to as sociopaths
or psychopaths, typically have a long history of conflict with
society.
Antisocial persons are irresponsible, lacking in judgment
and morals, and unable to learn from experience. They
are also incapable of deep feelings, including guilt, shame,
fear, loyalty, and love.
In short, the sociopath is poorly socialized and has a
general disregard for the truth (DSM-IV, 1994).
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Paraphilias (Coon, pgs. 504-505)
Compulsive or destructive deviations in sexual
preferences or behavior. Typically, they cause
guilt, anxiety, or discomfort for one or both
participants. The paraphilias cover a wide
variety of behaviors, including:
Pedophilia – sex with children, or child molesting.
Child molesters, who are usually males, are
often depicted as despicable perverts lurking in
dark alleys. In fact, most are married and two
thirds are fathers. Many are rigid, passive,
puritanical, or religious. In one half to two thirds
of all cases of pedophilia, the offender is a
friend, acquaintance, or relative of the child.
Molesters are also often thought of as child
rapists. However, most molestations rarely
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exceed fondling (Sue et al., 1996).
Paraphilias

Fetishism – sexual arousal associated with inanimate objects.

Exhibitionism – “flashing”, or displaying the genitals to unwilling viewers.
This is a common problem. Roughly 35% of all sexual arrests are for
“flashing”. Exhibitionists are typically male and married and most come from
strict or repressive backgrounds. They typically feel a deep sense of
inadequacy. This leads to a compulsive need to prove their “manhood” by
frightening women. Exhibitionists have the highest repeat rate among
sexual offenders. While they are usually harmless, those who approach
closer than arm’s reach may be dangerous. In general, a woman confronted
by an exhibitionist can assume that his goal is to shock and alarm her. By
becoming visibly upset she actually encourages him (Hyde, 1996).

Voyeurism – “peeping”, or viewing the genitals of others without their
permission.
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Paraphilias

Transvestic fetishism – achieving sexual arousal by
wearing clothing of the opposite sex.

Sexual sadism – deriving sexual pleasure from
inflicting pain.

Sexual masochism – desiring pain as part of the sex
act.

Frotteurism – sexually touching or rubbing against
a non-consenting person, usually in a public place
such as a subway.
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Agoraphobia
Agoraphobia (Nevid, Pg. 390): The person fears that
something extremely embarrassing will happen to them if
they leave the house or enter unfamiliar situations.
For example, an agoraphobic person may refuse to go outside
because she fears having a sudden attack of dizziness, or
diarrhea, or shortness of breath.
Being outside the home alone, being in a crowd, standing in
line, being on a bridge, or in a car, bus, or train can be
impossible for an agoraphobic.
About 7% of all adults suffer from agoraphobia during their
lifetime.
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Obsessive-Compulsive Disorder

Obsessive-Compulsive Disorder (Nevid, Pg. 391): an extreme
preoccupation with certain thoughts and compulsive performance of
certain behaviors. You have probably experienced a mild obsessional
thought, such as a song or stupid commercial jingle that repeats over and
over in your mind. This may be irritating, but it’s usually not terribly
disturbing. True obsessions are images or thoughts that intrude into
consciousness against a person’s will. They are so disturbing that they
can cause anxiety or extreme discomfort.

The most common obsessions are about violence or harm (such as
poisoning one’s spouse or being hit by a car), about being “dirty” or
“unclean”, about whether one has performed some action (such as turning
off the stove), and about committing immoral acts.

Obsessions usually give rise to compulsions. These are irrational
acts a person feels driven to repeat. Often, the compulsive act (for
example, washing one’s hands repeatedly) helps control or block out
anxiety caused by an obsession (the feeling of being “dirty” or “unclean”).
Compulsive attention to detail and rigidly following procedures and rules
makes the highly anxious person feel more secure. Doing so helps keep
activities totally under control.
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Psychosis and Delusion

Psychosis (Nevid, p.407; Coon pgs. 514-515): A
withdrawal from reality marked by hallucinations and
delusions, disturbed thought and emotions, and by
personality disorganization. Psychosis reflects a loss of
contact with shared views of reality. Paranoid psychosis
(Nevid, p. 408; Coon, p. 517) is a delusional disorder
centered especially on delusions of persecution (an
example is a UFO “abductee”).

Delusion (Nevid, p. 383; Coon pgs. 514-515): A false belief
held against all contrary evidence. Disturbed persons
insist their delusions are true, even when the facts
contradict them. An example is a 43 year old
schizophrenic man who was convinced he was pregnant
(Mansouri & Adityanjee, 1995).
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Hallucination and Dementia
Hallucination (Nevid, p.383; Coon, pgs. 514-515): An
imaginary sensation, such as seeing, hearing, or smelling
things that don’t exist in the real world. The most common
psychotic hallucination is hearing voices. Sometimes
these voices command patients to hurt themselves.
Unfortunately, many obey.
Dementia (Nevid, p.334; Coon, pgs. 516-517): Serious
mental impairment caused by physical deterioration of the
brain. In dementia, we see major disturbances in memory,
reasoning, judgment, impulse control, and personality. This
combination usually leaves the person confused, suspicious,
apathetic, or withdrawn.
The most common cause of dementia is Alzheimer’s disease
(an age related disease characterized by memory loss,
mental confusion, and in its later stages, by a nearly total loss
of mental abilities). Other common causes include circulatory
problems, repeated strokes, or general shrinkage and atrophy
of the brain.
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Schizophrenia, S.A.D., & Psychotherapy

Schizophrenia (Nevid, p.406; Coon, pgs. 518-519): A psychosis
characterized by delusions, hallucinations, apathy, and a “split”
between thought and emotion. One person in 100 will become
schizophrenic, and roughly half of all the people admitted to
mental hospitals are diagnosed as schizophrenic. Most are young
adults (remember the film in class about the adolescent brain?),
but schizophrenia can occur at any age.

Seasonal Affective Disorder (Coon, p. 527): Depression that
occurs only during fall and winter; presumably related to
decreased exposure to sunlight. Phototherapy involves exposing
SAD patients to one or more hours of very bright fluorescent light
each day. Light therapy works best when it is used early in the
morning.

Psychotherapy (Nevid, p. 418; Coon, p. 529): Any psychological
treatment for behavioral or emotional problems.
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