Download Chapter 12: Psychological Disorders

Psychology: A Journey, Second Edition, Dennis Coon
Chapter 12
Chapter 12
Psychological Disorders
Psychology: A Journey, Second Edition, Dennis Coon
Chapter 12
What is Normal?
• Psychopathology: Scientific study of mental, emotional,
and behavioral disorders
• Subjective Discomfort: Feelings of discomfort,
unhappiness, or emotional distress
• Statistical Abnormality: Having extreme scores on some
dimension, such as intelligence, anxiety, or depression
• Social Nonconformity: Disobeying societal standards for
normal conduct; usually leads to destructive or selfdestructive behavior
Figure 12.1
Psychology: A Journey, Second Edition, Dennis Coon
Chapter 12
FIGURE 12.1 The number of people displaying a personal characteristic may help define
what is statistically abnormal.
Psychology: A Journey, Second Edition, Dennis Coon
Chapter 12
What Is Normal? (cont'd)
• Situational Context: Social situation, behavioral setting,
or general circumstances in which behavior takes place
– Is it normal to walk around strangers naked? If you
are in a locker room and in the shower area, yes!
• Cultural Relativity: Judgments are made relative to the
values of one’s culture
Psychology: A Journey, Second Edition, Dennis Coon
Chapter 12
Clarifying and Defining Abnormal Behavior
(Mental Illness)
 Maladaptive Behavior: Behavior that makes it difficult to
function, to adapt to the environment, and to meet
everyday demands
 Mental Disorder: Significant impairment in psychological
functioning
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Chapter 12
Clarifying and Defining Abnormal Behavior
(Mental Illness)
• Psychotic Disorder: Severe psychiatric disorder
characterized by hallucinations and delusions, social
withdrawal, and a move away from reality
• Organic Mental Disorder: Mental or emotional problem
caused by brain pathology (i.e., brain injuries or
diseases)
• Mood Disorder: Disturbances in affect (emotions), like
depression or mania
• Anxiety Disorder: Feelings of fear, apprehension,
anxiety, and distorted behavior
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Chapter 12
Clarifying and Defining Abnormal Behavior
(Mental Illness)
• Substance Related Disorders: Abuse or dependence on
a mind or mood-altering drug, like alcohol or cocaine
– Person cannot stop using the substance and may
suffer withdrawal symptoms if they do
• Neurosis: Archaic; once used to refer to excessive
anxiety, somatoform, dissociative disorders, and some
kinds of depression
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Chapter 12
DSM
• DSM—Diagnostic & Statistical Manual of
Mental Disorders
• Published by American Psychiatric
Association
• used by clinicians and researchers to
diagnose and classify mental disorders
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Chapter 12
General Risk Factors for
Contracting Mental Illness
• Biological Factors: Genetic defects or inherited
vulnerabilities; poor prenatal care, head injuries,
exposure to toxins, chronic physical illness, or disability
• Psychological Factors: Low intelligence, learning
disorders
________________
• Social Conditions: Poverty, homelessness,
overcrowding, stressful living conditions
• Family Factors: Parents who are immature, mentally ill,
abusive, or criminal; poor child discipline; severe marital
or relationship problems
• Other sources of psychological stress
Figure 12.11
Psychology: A Journey, Second Edition, Dennis Coon
Chapter 12
FIGURE 12.11 A combination of vulnerability and stress may produce psychological problems.
The top bar shows low vulnerability and low stress. The result? No problem. The same is true of
the next bar down, where low vulnerability is combined with moderate stress. Even high
vulnerability (third bar) may not lead to problems if stress levels remain low. However, when
high vulnerability combines with moderate or high stress (bottom two bars) the person “crosses
the line” and suffers from psychopathology.
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Chapter 12
Anxiety-Based Disorders
• Anxiety: Feelings of apprehension, dread, or uneasiness
• Adjustment Disorders: When ongoing stressors cause
emotional disturbance and push people beyond their
ability to effectively cope
– Usually suffer sleep disturbances, irritability, and
depression
– Examples: Grief reactions, lengthy physical illness,
unemployment can be some triggers for anxiety
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Chapter 12
Anxiety-Based Disorders (cont'd)
•
•
1.
2.
3.
Anxiety Disorders: When stress seems greatly out of
proportion to the situation at hand …usually
accompanied by some form of avoidance
3 Main Types
Generalized Anxiety Disorder (GAD): Duration of at
least six months of chronic, unrealistic, or excessive
anxiety
Panic Disorder (w/ or w/o agoraphobia)
Phobia
Psychology: A Journey, Second Edition, Dennis Coon
Chapter 12
Generalized Anxiety Disorder
• Extreme anxiousness and worry for at
least 6 months
• Anxiousness/anxiety do not fade when life
circumstances get better
• Multiple topics of worry
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Chapter 12
Panic Disorders
• Panic Disorder (without Agoraphobia): A chronic state of
anxiety with brief moments of sudden, intense,
unexpected panic (panic attack)
– Panic Attack: Feels like one is having a heart attack,
going to die, or is going insane
– Symptoms include vertigo, chest pain, choking, fear
of losing control
• Panic Disorder (with Agoraphobia): Panic attacks and
sudden anxiety still occur, but with agoraphobia
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Chapter 12
Agoraphobia
• Agoraphobia (with Panic Disorder): Intense, irrational
fear that a panic attack will occur in a public place or in
an unfamiliar situation
– Intense fear of leaving the house or entering
unfamiliar situations
– Can be very crippling
– Literally means fear of open places or market (agora)
• Agoraphobia (without Panic Disorder): Fear that
something extremely embarrassing will happen away
from home or in an unfamiliar situation.
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Chapter 12
Specific Phobias
• Irrational, persistent fears, anxiety, and avoidance that
focus on specific objects, activities, or situations
• People with phobias realize that their fears are
unreasonable and excessive, but they cannot control
them.
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Chapter 12
Social Phobia
• Intense, irrational fear of being observed, evaluated,
humiliated, or embarrassed by others (e.g., shyness,
eating, or speaking in public)
Psychology: A Journey, Second Edition, Dennis Coon
Chapter 12
Review: 3 Anxiety Disorders
• 1. Phobia—objects, situation, social
– Causes: not only experience…also inherit
tendencies (prepared fears)
• 2. Generalized Anxiety—constant anxiety
and worry
• 3. Panic Disorder—discrete panicky
episodes
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Chapter 12
Obsessive-Compulsive Disorder (OCD)
• Extreme preoccupation with certain thoughts and
compulsive performance of certain behaviors
• Obsession: Recurring images or thoughts that a person
cannot prevent
– Cause anxiety and extreme discomfort
– Enter into consciousness against the person’s will
– Most common: Being dirty or wondering if you
performed an action (turned off the stove)
Psychology: A Journey, Second Edition, Dennis Coon
Chapter 12
Compulsions
• Compulsion: Irrational acts that person feels compelled
to repeat against his/her will
– Help to control anxiety created by obsessions
– Checkers and cleaners
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Chapter 12
Table 16.2
Obsessive-Compulsive Tendencies
Psychology: A Journey, Second Edition, Dennis Coon
Chapter 12
Anxiety
• Feelings of tension, uneasiness,
apprehension, worry, and vulnerability
– We are motivated to avoid experiencing
anxiety
Figure 10.6
Psychology: A Journey, Second Edition, Dennis Coon
Chapter 12
FIGURE 10.6 The approximate relationship between the id, ego, and superego, and the levels
of awareness.
Psychology: A Journey, Second Edition, Dennis Coon
Chapter 12
Theoretical Causes of Anxiety Disorders:
Psychodynamic
• Psychodynamic (Freud): Anxiety caused by conflicts
among id, ego, and superego.
• Forbidden id impulses for sex or aggression are
trying to break into consciousness and thus
influence behavior; person fears doing something
crazy or forbidden.
• Superego creates guilt in response to these
impulses.
• Ego gets overwhelmed and uses defense
mechanisms to cope.
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Chapter 12
Other Theoretical Causes of Anxiety
Disorders
• Humanistic-Existential: Unrealistic selfimage conflicts with true self
Psychology: A Journey, Second Edition, Dennis Coon
Chapter 12
Other Theoretical Causes of Anxiety
Disorders
• Behavioristic: Anxiety symptoms and
behaviors are learned, like everything else
– Conditioned emotional responses generalize
to new situations
– Anxiety Reduction Hypothesis: When reward
of immediate relief from anxiety perpetuates
self-defeating avoidance behaviors
• Cognitive: When distorted thinking causes
people to magnify ordinary threats and
failures, leading to anxiety and distress
Psychology: A Journey, Second Edition, Dennis Coon
Chapter 12
Mood Disorders
• Major disturbances in emotion, such as depression or
mania
• Depressive Disorders: Sadness or despondency are
prolonged, exaggerated, or unreasonable
• Bipolar Disorders: Involve both depression, and mania or
hypomania
• Seasonal Affective Disorder (SAD): Depression that only
occurs during fall and winter.
– May be related to reduced exposure to sunlight
– Phototherapy: Extended exposure to bright light to
treat SAD
Psychology: A Journey, Second Edition, Dennis Coon
Chapter 12
Major Mood Disorders
• Lasting extremes of mood or emotion and sometimes
with psychotic features (hallucinations, delusions)
• Major Depressive Disorder: A mood disorder where the
person has suffered one or more intense episodes of
depression; one of the more serious mood disorders.
• Bipolar I Disorder: Extreme mania and deep depression;
one type of manic-depressive illness.
– Mania: Excited, hyperactive, energetic, grandiose
behavior
• Bipolar II Disorder: Person is mainly sad but has one or
more hypomanic episodes (mild mania)
Psychology: A Journey, Second Edition, Dennis Coon
Chapter 12
Suicide: Major Risk Factors
•
•
•
•
•
•
•
Drug or alcohol abuse
Prior suicide attempt
Depression or other mood disorder
Availability of a firearm
Severe anxiety or panic attacks
Family history of suicidal behavior
Shame, humiliation, failure or rejection
Figure 12.15
Psychology: A Journey, Second Edition, Dennis Coon
Chapter 12
FIGURE 12.15 Suicidal behavior usually progresses from suicidal thoughts, to threats, to
attempts. A person is unlikely to make an attempt without first making threats. Thus, suicide
threats should be taken seriously
Psychology: A Journey, Second Edition, Dennis Coon
Chapter 12
Common Characteristics of Suicidal
Thoughts and Feelings (Shneidman)
• Escape
• Unbearable Psychological Pain: Emotional pain that the
person wishes to escape
• Frustrated Psychological Needs: Such as searching for
love, achievement, or security
• Constriction of Options: Feeling helpless and hopeless
and deciding that death is the only option left
Psychology: A Journey, Second Edition, Dennis Coon
Chapter 12
Psychosis
• Psychosis: Loss of contact with reality marked by
hallucinations, delusions, disturbed thoughts and
emotions, and personality disorganization
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Chapter 12
Schizophrenia:
The Most Severe Mental Illness
• Psychotic disorder characterized by hallucinations,
delusions, apathy, thinking abnormalities, and “split”
between thoughts and emotions
– Does NOT refer to having split or multiple
personalities
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Chapter 12
Delusions
• Delusions: False beliefs that psychotic individuals insist
are true, regardless of overwhelming evidence against
them
• Common forms:
– Erotomanic
– Grandiose
– Jealous
– Persecution
– Somatic
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Chapter 12
Hallucinations
• Hallucinations: Imaginary sensations, such as seeing,
hearing, or smelling things that do not exist in the real
world
– Most common psychotic hallucination is hearing
voices
– Note that olfactory hallucinations sometimes occur
with seizure disorder (epilepsy)
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Chapter 12
Some More Psychotic Symptoms
• Flat Affect: Lack of emotional responsiveness
• Inappropriate emotions:
• Disturbed Verbal Communication: Garbled and chaotic
speech; word salad
• Personality Disintegration: Uncoordinated thoughts,
actions, and emotions…a “split” between thought and
emotion
• Withdrawal and apathy
• Breakdown of personal habits
• Problems with selective attention
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Chapter 12
Causes of Schizophrenia
• Psychological Trauma: Psychological injury or shock,
often caused by an environment of violence, abuse, or
neglect
• Disturbed Family Environment: Stressful or unhealthy
family relationships, communication patterns, and
emotional atmosphere
• Deviant Communication Patterns: Cause guilt, anxiety,
anger, confusion, and turmoil
• Heredity—if one identical twin becomes schizophrenic
then the other twin has about 50% chance
• Stress-Vulnerability Hypothesis: Combination of
environmental stress and inherited susceptibility cause
psychotic disorders
Figure 12.7
Psychology: A Journey, Second Edition, Dennis Coon
Chapter 12
FIGURE 12.7 Lifetime risk of developing schizophrenia is associated with how closely a person
is genetically related to a schizophrenic person. A shared environment also increases the risk.
Psychology: A Journey, Second Edition, Dennis Coon
Chapter 12
Biochemical Causes of Schizophrenia
• Biochemical Abnormality: Disturbance in brain’s
chemical systems or in the brain’s neurotransmitters
• Dopamine: Neurotransmitter involved with emotions and
muscle movement
– Works in limbic system
• Dopamine overactivity in brain may be related to
schizophrenia
• Glutamate may also be related to schizophrenia
Figure 12.8
Psychology: A Journey, Second Edition, Dennis Coon
Chapter 12
FIGURE 12.8 Dopamine normally crosses the synapse between two neurons, activating the
second cell. Antipsychotic drugs bind to the same receptor sites as dopamine does, blocking
its action. In people suffering from schizophrenia, a reduction in dopamine activity can quiet a
person’s agitation and psychotic symptoms.