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Abnormal Psychology
Psychological Disorders
Chapter 14
1
Defining Psychological Disorders
Mental health workers view psychological
disorders as persistently harmful thoughts,
feelings, and actions.
When behavior is deviant, distressful, and
dysfunctional psychiatrists and psychologists
label it as disordered (Comer, 2004).
Intern’s Syndrome - diagnose yourself or
those around you while studying a particular
disorder
2
Deviant, Distressful & Dysfunctional
 Maladaptive
Carol Beckwith
1. Deviant behavior
(going naked) in one
culture may be
considered normal,
while in others it may
lead to arrest.
2. Deviant behavior must
accompany distress.
3. If a behavior is
dysfunctional it is
clearly a disorder.
In the Wodaabe tribe men
wear costumes to attract
women. In Western society
this would be considered
abnormal.
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Abnormality
 Statistically rare
 Deviant from social norms
 Situational context - the social or environmental
setting of a person’s behavior.
 Subjective discomfort - emotional distress
or emotional pain.
 Maladaptive - anything that does not allow a
person to function within or adapt to the
stresses and everyday demands of life.
Abnormality vs. Insanity
 Insanity is a legal term
 The insanity defense is used to argue that a
mentally ill person should not be held
responsible for his or her actions.
 Not everyone diagnosed with a mental
disorder would be able to claim insanity –
that designation is determined by judges
and juries.
Understanding Psychological Disorders
Ancient Treatments of psychological
disorders include trephination, exorcism,
being caged like animals, being beaten,
burned, castrated, mutilated, or transfused
with animal’s blood.
John W. Verano
Trephination (boring holes in the skull to remove evil forces)
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Perspectives and Disorders
Psychological School/Perspective
Psychoanalytic/Psychodynamic
Cause of the Disorder
Internal, unconscious drives
Humanistic
Failure to strive to one’s potential or
being out of touch with one’s feelings.
Behavioral
Reinforcement history, the
environment.
Cognitive
Irrational, dysfunctional thoughts or
ways of thinking.
Sociocultural
Biomedical/Neuroscience
Dysfunctional Society
Organic problems, biochemical
imbalances, genetic predispositions.
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Medical Perspective
Philippe Pinel (1745-1826) from France,
insisted that madness was not due to demonic
possession, but an ailment of the mind.
George Wesley Bellows, Dancer in a Madhouse, 1907. © 1997 The Art Institute of Chicago
Dance in the madhouse.
8
Medical Model
When physicians discovered that syphilis led to
mental disorders, they started using medical
models to review the physical causes of these
disorders.
1.
2.
3.
4.
Etiology: Cause and development of the
disorder.
Diagnosis: Identifying (symptoms) and
distinguishing one disease from another.
Treatment: Treating a disorder in a
psychiatric hospital.
Prognosis: Forecast about the disorder.
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Biopsychosocial Perspective
10
DSM IV
 Diagnostic Statistical
Manual of Mental
Disorders: the big book
of disorders.
 Operational definitions
of each disorder
 DSM will classify
disorders and describe
the symptoms.
 DSM will NOT explain
the causes or possible
cures.
 400 psychological
disorders compared to
60 in 1950’s
11
Two Major Classifications in the
DSM
Neurotic Disorders
 Distressing but one can
still function in society
and act rationally.
Psychotic Disorders
 Person loses contact
with reality,
experiences distorted
perceptions.
John Wayne Gacy
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Multiaxial Classification
Axis I
Axis II
Axis III
Axis IV
Axis V
Is a Clinical Syndrome (cognitive, anxiety, mood disorders
[16 syndromes]) present?
Is a Personality Disorder or Mental Retardation present?
Is a General Medical Condition (diabetes, hypertension or
arthritis etc) also present?
Are Psychosocial or Environmental Problems (school or
housing issues) also present?
What is the Global Assessment of the person’s
functioning?
13
Goals of DSM
1.
2.
Describe (400) disorders.
Determine how prevalent the
disorder is.
Disorders outlined by DSM-IV are reliable.
Therefore, diagnoses by different
professionals are similar.
Others criticize DSM-IV for “putting any
kind of behavior within the compass of
psychiatry.”
14
Labeling Psychological Disorders
1.
Critics of the DSM-IV argue that labels may
stigmatize individuals.
2. David Rosenhan “pseudopatient” study 1970
Elizabeth Eckert, Middletown, NY. From L. Gamwell and
N. Tomes, Madness in America, 1995. Cornell University
Press.
Asylum baseball team (labeling)
15
Labeling Psychological Disorders
Elaine Thompson/ AP Photo
3. Labels may be helpful
for healthcare
professionals when
communicating with
one another and
establishing therapy.
4. “Insanity” labels raise
moral and ethical
questions about how
society should treat
people who have
disorders and have
committed crimes.
Theodore Kaczynski
(Unabomber)
16
Anxiety Disorders
 A group of conditions
where the primary
symptoms are anxiety
or defenses against
anxiety.
 the patient fears
something awful will
happen to them.
 They are in a state of
intense apprehension,
uneasiness,
uncertainty, or fear.
 Important that their
behavior is maladaptive
17
Phobias
 A person experiences
sudden episodes of
intense dread.
 Must be a deep seated,
irrational fear.
 3 Basic Categories
 Specific
 Social
 Agoraphobia
 Phobia List
18
Generalized Anxiety Disorder
GAD
 An anxiety disorder in which
a person is continuously
tense, apprehensive and in a
state of autonomic nervous
system arousal.
 The patient is constantly
tense and worried, feels
inadequate, is oversensitive,
can’t concentrate and
suffers from insomnia.
 No specific stimulus
 Free Floating
19
Panic Disorder
 An anxiety disorder marked
by a minutes-long episode of
intense dread in which a
person experiences terror and
accompanying chest pain,
choking and other frightening
sensations.
 Can be recurrent; unexpected
 Symptoms: chest pain, muscle
tightness, numbness and
dizziness
20
Obsessive-compulsive disorder
 Persistent unwanted
thoughts (obsessions)
cause someone to feel the
need (compulsion) to
engage in a particular
action.
 Interfere with everyday
living and cause the person
distress
 Example: Obsession about
dirt and germs may lead to
compulsive hand washing.
21
Obsessive-Compulsive Disorder
22
Brain Imaging
A PET scan of the brain
of a person with
Obsessive-Compulsive
Disorder (OCD). High
metabolic activity (red) in
the frontal lobe areas are
involved with directing
attention.
Brain image of an OCD
23
Post-Traumatic Stress Disorder
Four or more weeks of the following
symptoms constitute post-traumatic stress
disorder (PTSD) after a deeply troubling
event:
1. Haunting memories
2. Nightmares
3. Social withdrawal
Bettmann/ Corbis
4. Jumpy anxiety
5. Sleep problems
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Resilience to PTSD
Only about 10% of women and 20% of men
react to traumatic situations and develop
PTSD.
Survivor Resilience- Holocaust survivors show
remarkable resilience against traumatic
situations.
Post-traumatic Growth- All major religions of
the world suggest that surviving a trauma
leads to the growth of an individual and a new
positive view on life.
25
Causes of Anxiety Disorders
 Psychoanalytic explanations point to repressed urges
and desires that are trying to come into conscious,
creating anxiety that is controlled by the abnormal
behavior.
 Behaviorists state that disordered behavior is learned
through both positive and negative reinforcement;
conditioning; observation
 Cognitive psychologists believe that excessive anxiety
comes from illogical, irrational thought processes.
 Biological explanations of anxiety disorders include
chemical imbalances in the nervous system, in particular
serotonin and GABA systems; biologically prepared
Somatoform Disorders
 Occur when a
person manifests a
psychological
problem through a
physiological
symptom without a
physiological cause
 Three types……
27
Hypochondriasis
 Has frequent physical
complaints for which
medical doctors are
unable to locate the
cause.
 They usually believe
that the minor issues
(headache, upset
stomach) are
indicative are more
severe illnesses.
28
Conversion Disorder
 Report the existence of
severe physical problems
with no biological reason;
tied with psychological
stress
 Like blindness, paralysis,
pain, or the inability to
swallow.
29
Body Dysmorphic Disorder
 Intense anxiety about
perceived physical
deformity or defect
 Flaw is usually minor or
imagined
 Western Civilization
and its effect…
Dissociative Disorders
 These disorders involve
a disruption in the
conscious process.
 Separated from previous
memories, thoughts, and
feelings in response to a
stressful situation
 Three types….
31
Dissociative Amnesia
 A large scale loss of
memory for events or
one’s own identity
 Injury or highly
traumatic event
 Retrograde Amnesia
32
Dissociative Fugue
 People with
psychogenic amnesia
that find themselves in
an unfamiliar
environment.
 People travel miles
from home unaware of
how they got there
 “Traveling Amnesia”
33
Dissociative Identity Disorder
 Used to be known as
Multiple Personality
Disorder.
 A person exhibits two
or more distinct and
alternating
personalities
 May not know about one
another
 People with DID
commonly have a history
of childhood abuse or
trauma.
34
DID Critics
Critics argue that the diagnosis of DID
increased in the late 20th century. DID has
not been found in other countries.
Critics’ Arguments
1.
Role-playing by people open to a
therapist’s suggestion.
2. Learned response that reinforces
reductions in anxiety.
Psychoanalytic Viewpoint – protect us against a painful memory
35
Mood Disorders
 Experience extreme or inappropriate
emotion.
 Also known as Affective Disorders
36
Major Depression
 A.K.A. unipolar depression
 Unhappy for at least two
weeks with no apparent
cause.
 Sadness, hopelessness and
worthlessness, loss of
energy, changes in appetite
and sleep
 Depression is the common
cold of psychological
disorders.
 5.8% Men vs. 9.5% Women 37
Theory of Depression
Gender differences
Women get sadder, men get madder.
38
Neurotransmitters & Depression
•A reduction of
norepinephrine and
serotonin has been
found in depression.
•Drugs that alleviate
mania reduce
norepinephrine.
Pre-synaptic
Neuron
Norepinephrine
Serotonin
Post-synaptic
Neuron
39
The Depressed Brain & Genetic Influences
PET scans show that brain energy consumption
rises and falls with manic and depressive
episodes. (Left Frontal Lobe)
Identical Twins- 1 in 2 will have depressive
disorder; 7 in 10 will have bipolar disorder
40
Seasonal Affective Disorder
 Experience depression
during the winter months.
 Based not on temperature,
but on amount of sunlight.
 Treated with light
therapy.
 Vitamin D
41
Seasonal Affective Disorder
Bipolar Disorder
 Formally manic
depression.
 Involves periods of
depression and manic
episodes.
 Manic episodes involve
feelings of high energy,
euphoria, inflated self
esteem
 but they tend to differ a
lot…some get confident
and some get irritable
 Engage in risky behavior
during the manic episode.
43
Bipolar Disorder
Many great writers, poets, and composers
suffered from bipolar disorder. During their
manic phase creativity surged, but not during
their depressed phase.
Hemingway
Earl Theissen/ Hulton Getty Pictures Library
Clemens
The Granger Collection
Wolfe
George C. Beresford/ Hulton Getty Pictures Library
Bettmann/ Corbis
Whitman
44
Your turn…
Explain mood disorders from the following
perspectives:
 Behavioral
 Psychodynamic
 Humanistic
 Cognitive
 Socio-cultural
 Biological
Causes of Mood Disorders
 Psychoanalytic theories see depression as
anger at authority figures from childhood
turned inward on the self.
 Learning theories link depression to learned
helplessness; can be reinforced
 Cognitive theories see depression as the
result of distorted, illogical thinking.
 Internal, Stable, Logical
 Biological explanations of mood disorders
look at the function of serotonin,
norepinephrine, and dopamine systems in the
brain.
Personality Disorders
 Well-established,
maladaptive ways of
behaving that
negatively affect
people’s ability to
function.
 Dominates their
personality.
 Hard to tell apart
and treat
47
Antisocial Personality Disorder
 Lack of empathy.
 Little regard for other’s
feelings.
 View the world as hostile
and look out for
themselves.
 Manipulative, rebellious,
hurtful
 Sociopath or psychopath
 Conduct Disorder
48
Understanding Antisocial
Personality Disorder
PET scans of 41 murderers revealed reduced
activity in the frontal lobes. In a follow-up
study repeat offenders had 11% less frontal
lobe activity compared to normals (Raine et al.,
1999; 2000).
Murderer
Courtesy of Adrian Raine,
University of Southern California
Normal
49
Histrionic Personality Disorder
 Needs to be the center
of attention and a
tendency toward highly
emotional behavior.
 Whether acting silly or
dressing provocatively.
50
Narcissistic Personality Disorder
 Having an unwarranted
sense of selfimportance and an
extreme preoccupation
with themselves.
 Thinking that you are
the center of the
universe.
51
Paranoid Personality Disorder
 Persistent suspicion
marked by the
chronic sense of
being observed and
persecuted
 Highly suspicious of
others
Borderline Personality Disorder
 Sudden and intense rages,
deep insecurity and fear of
abandonment, and general
instability in relationships
 Impulsive
 High suicide risk group
53
Dependent Personality Disorder
 Extreme dependence
on others, submissive
and clingy behavior,
difficulty making
decisions, and
helplessness
Causes of Personality Disorders
 Psychoanalysts blame an inadequate resolution to the
Oedipal complex for personality disorders, stating that
this results in a poorly developed superego.
 Cognitive-learning theorists see personality disorders as
a set of learned behavior that has become maladaptive—
bad habits learned early on in life.
 Biological explanations look at the lower than normal
stress hormones in antisocial personality disordered
persons as responsible for their low responsiveness to
threatening stimuli.
 Other possible causes of personality disorders may
include disturbances in family communications and
relationships, childhood abuse, neglect, overly strict
parenting, overprotective parenting, and parental
rejection.
Schizophrenic Disorders
 If depression is the common cold
of psychological disorders,
schizophrenia is the cancer.
 About 1 in every 100 people are
diagnosed with schizophrenia.
 Schizophrenia strikes young
people as they mature into
adults.

It affects men and women equally,
but men suffer from it more
severely than women.
 Symptoms of Schizophrenia
1. Disorganized thinking.
2. Disturbed Perceptions
3. Inappropriate Emotions and
Actions
56
Disorganized Thinking
 The thinking of a
person with
Schizophrenia is
fragmented and bizarre
and distorted with
false beliefs.
 Word Salad
 Disorganized thinking
comes from a
breakdown in selective
attention.- they cannot
filter out information.
57
Disturbed Perceptions
 hallucinationssensory experiences
without sensory
stimulation.
 Usually auditory
 The do not exist!
58
Disturbed Perceptions
 Delusions- false beliefs
 Delusions of Persecution
or Paranoia
 Delusions of Grandeur
 Delusions of Reference
 Beautiful Mind
59
Inappropriate Emotions and
Actions
 Apathy
 Laugh at inappropriate times.
 may laugh at the news of someone
dying or
 Flat Effect- show no emotion at all
 Catatonia
 motionless Waxy Flexibility
 senseless, compulsive acts.
 may continually rub an arm, rock a chair,
or remain motionless for hours
60
Types of Schizophrenia
61
Positive and Negative Symptoms
Positive Symptoms
Schizophrenics have inappropriate symptoms
(hallucinations, disorganized thinking, deluded ways)
that are not present in normal individuals.
(presence)
Negative Symptoms
Schizophrenics also have an absence of appropriate
symptoms (apathy, expressionless faces, rigid bodies)
that are present in normal individuals.
(absence)
62
Subtypes
63
Understanding Schizophrenia:
Biological Model
Schizophrenia is a disease of the brain
exhibited by the symptoms of the mind.
Brain Abnormalities
Dopamine Overactivity: Researchers found
that schizophrenic patients express higher
levels of dopamine D4 receptors in the brain.
64
Abnormal Brain Activity
Brain scans show abnormal activity in the
frontal cortex, thalamus, and amygdala of
schizophrenic patients. Adolescent
schizophrenic patients also have brain lesions.
Paul Thompson and Arthur W. Toga, UCLA Laboratory of
Neuro
Imaging and Judith L. Rapport, National Institute of
Mental Health
65
Abnormal Brain Morphology
Schizophrenia patients may exhibit
morphological changes in the brain like
enlargement of fluid-filled ventricles.
Effects frontal lobes and temporal lobes
Both Photos: Courtesy of Daniel R. Weinberger,
M.D., NIH-NIMH/ NSC
66
Viral Infection
Schizophrenia has also been observed in
individuals who contracted a viral infection
(flu) during the middle of their fetal
development.
Low birth weight and lack of oxygen may
also contribute to higher risk of
Schizophrenia.
Disruptions of the normal maturation
process of the brain
67
Genetic Factors
The likelihood of an individual suffering
from schizophrenia is 50% if their identical
twin has the disease (Gottesman, 1991).
0
10
20
30
40
50
Identical
Both parents
46x
Fraternal
One parent
6x
Sibling
Nephew or niece
Unrelated
68
Genetic Factors
The following shows the prevalence of
schizophrenia in identical twins as seen in
different countries. Averages out to about
1 in 2
69
Diathesis-Stress Model
Psychological and environmental factors can
trigger schizophrenia if the individual is
genetically predisposed (Nicols &
Gottesman, 1983).
Socio-cultural Perspective
Income levels and home environments
can play a role
Low socioeconomic correlation
70
Warning Signs
Early warning signs of schizophrenia include:
1.
A mother’s long lasting schizophrenia.
2.
Birth complications, oxygen deprivation and low-birth
weight.
3.
Short attention span and poor muscle coordination.
4.
Disruptive and withdrawn behavior.
5.
Emotional unpredictability.
6.
Poor peer relations and solo play.
71