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General Psychology
Chapter 12
The Psychological Disorders
What is “Abnormal”?
 Abnormal refers to maladaptive affects,
behaviors, and/or cognitions that are at odds
with social expectations and result in
distress or discomfort
Classifying Abnormal Reactions
 Diagnosis – act of recognizing a disorder on
the basis of a specified set of symptoms
 The Diagnostic and Statistical Manual of
Mental Disorders (DSM)
 DSM-IV lists 297 different diagnostic
categories
Table 12.1: The multiaxial classification system of the DSM-IV-TR.
Problems with
Classification & Labeling
 Comorbidity – occurrence of two or more
disorders in the same individual
 Nearly 80% will have 2 or more disorders
 Many psychological disorders are also
comorbid with physical illness
A Word on “Insanity”
 Insanity:
 One did not know or fully understand the
consequences of his or her actions at a given
time
 Could not discern the difference between right
and wrong
 And was unable to exercise control over his or
her actions at the time a crime was committed
A Word on “Insanity”
 Competence – whether one is in control of
his or her mental and intellectual functions
to understand courtroom procedures and aid
in his or her own defense
A Few Cautions…
 “Abnormal” and “normal” are not 2 distinct
categories!
 Abnormal does not mean dangerous
 People jailed for violent crimes are no more likely to
have a psychological disorder than not-jailed persons
 Persons with psychological disorders are more likely
(than persons without) to be victims of violent crimes
 Abnormal also does not mean BAD!
Anxiety Disorders
 Anxiety – feeling of general apprehension
or dread accompanied by predictable
physiological changes
Anxiety Disorders
 Generalized anxiety disorder – major
symptom is distressing, felt anxiety
 Anxiety may be intense or diffuse
 Anxiety can cause substantial interference
Anxiety Disorders
 Panic Disorder – major symptom is more
acute: a recurrent, unpredictable,
unprovoked onset of sudden, intense
anxiety, or a “panic attack”
 Comorbid with depression = higher rate of
suicide
Anxiety Disorders
 Phobic disorder – persistent and excessive
fear of some object, activity, or situation
that consistently leads a person to avoid that
object, activity, or situation
 Specific phobia
 Social phobia
 Agoraphobia
Table 12.2: A sample of phobias.
Obsessive-Compulsive Disorder
 OCD – anxiety disorder characterized by a
pattern of recurrent obsessions and
compulsions
 Obsessions – ideas or thoughts that
involuntarily and constantly intrude into
awareness
 Compulsions – constantly intruding, repetitive,
behaviors
Table 12.3: A few of the more common obsessions and compulsions found in patients with OCR.
Posttraumatic Stress Disorder
 PTSD – distressing symptoms that arise
some time after the experience of a highly
traumatic event
 Must have experienced, witnessed, or been
confronted with an event that involves actual or
threatened death or serious injury
 Responses involve fear, helplessness, and
horror
 Flashbacks, Avoidance, Increased Arousal
Somatoform Disorders
 Somatoform disorders – involve physical,
bodily symptoms or complaints with no
known medical or biological cause for the
symptoms
Somatoform Disorders
 Hypochondriasis – preoccupied with the fear of a
serious disease
 Somatization disorder – several, recurrent, longlasting complaints about physical symptoms for which
there is no cause
 Conversion disorder – loss or altering of physical
functioning that suggests a physical disorder, but
without medical explanation. La belle indifference
Dissociative Disorders
 Dissociative disorders – person seeks to
escape from some aspect of life or
personality seen as the source of stress,
discomfort, or anxiety
Dissociative Disorders
 Dissociative amnesia – inability to recall
important personal information too
extensive to be explained by ordinary
forgetfulness
 Dissociative fugue – amnesic forgetfulness is
accompanied by a change of location
Dissociative Identity Disorder
 Major symptom is the existence within the same
person of two or more distinct personalities or
traits
 Dramatic and extreme personality changes
 Take place without warning or provocation
 Which personality will be dominant cannot be predicted
or controlled
 Child/sexual abuse
Personality Disorders
 Long-lasting patterns of perceiving, relating
to, and thinking about the environment and
oneself that are maladaptive and inflexible
and cause either impaired functioning or
distress
Personality Disorders
 Cluster I – includes disorders of odd or
eccentric reactions, such as:
 Paranoid personality disorder – extreme
sensitivity, unjustified suspiciousness, envy,
and mistrust of others
 Schizoid personality disorder – inability to
form, and an indifference to, personal
relationships
Personality Disorders
 Cluster II – disorders of dramatic,
emotional, or erratic reactions, such as:
 Histrionic personality disorder – someone
who is overly dramatic, reactive, and
demonstrates intensely expressed behavior
 Narcissistic personality disorder – reflects a
grandiose exaggeration of self-importance, a
need for attention or admiration, and a tendency
to set unrealistic goals
Personality Disorders
 Cluster III – disorders involving anxiety and
fearfulness, such as:
 Avoidant personality disorder – an over-sensitivity to
the possibility of being rejected by others and an
unwillingness to enter into relationships for fear of
being rejected
 Dependent personality disorder – allowing and
seeking others to dominate and assume responsibility
for action; has poor self-image and lacks selfconfidence
Personality Disorder
 Antisocial personality disorder – an
exceptional lack of regard for the rights and
properties of others, accompanied by
impulsive, often criminal, behaviors
 Psychopaths/Sociopaths
 Symptoms include deceit and manipulation of
others without guilt or regret
 More common among persons of low-SES
Alzheimer’s Dementia
 Dementia – condition characterized by the
marked loss of intellectual abilities
 Alzheimer’s disease – slow deterioration of
intellectual functioning accompanied by
personality changes
 Physical disease
 Abnormal changes in brain tissue
Table 12.4: Ten warning signs of Alzheimer’s disease.
Alzheimer’s Dementia
 Risk Factors for Alzheimer’s:
 There is a genetic predisposition!
 Obesity
 Receiving a head injury
Alzheimer’s Dementia
 Possibly reduces chances of Alzheimer’s:
 Using folic acid in one’s diet
 Engaging in cognitively challenging activities
in old age
Mood Disorders
 Major depression – diagnosis for a
constellation of symptoms that includes
feeling sad, low, and hopeless, coupled with
a loss of pleasure or interest in most normal
activities
 Dysthymia – mild case of major
depression, but it tends to be more chronic,
or continuous
Mood Disorders
 Bipolar Disorder – episodes of depression
are occasionally interspersed with episodes
of mania
 Mania – elevated mood with feelings of
euphoria or irritability and increased levels
of activity
The Roots of Depression
 There is evidence for a genetic, or inherited,
predisposition to bipolar mood disorder
 Researchers suspect that there is a genetic
basis for major depression, as well
The Roots of Depression
 Diathesis-stress model – the expression of
disordered behaviors (particularly
depression) results from the interaction of
an inherited predisposition and the
experience of stress or trauma
 Biogenic amines
 Brain anatomy
The Roots of Depression
 Psychological Factors
 These could include learning experiences,
situational stress, and cognitive factors
 Freud believed that depression was a
reflection of early childhood experiences
that leads to anger directed inwardly
Schizophrenia


Involves a distortion of reality and a
retreat from other people.
Three dimensions of symptoms:
1. Negative symptoms – emotional and social
withdrawal, reduced energy and motivation,
apathy and poor attention
Schizophrenia
2. Positive symptoms:
a. Hallucinations – false perceptions
b. Delusions – false beliefs
3. Positive disorganized symptoms – disorders
of thinking and speech, bizarre behaviors,
inappropriate affect
Schizophrenia:
Correlates of Negative Symptoms
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

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Structural abnormalities in the brain
Clearer genetic basis
More severe complications at birth
A lower educational level
Poorer adjustment patterns before onset
Poorer prognosis
Schizophrenia:
Correlates of Positive Symptoms




Excesses of the neurotransmitter dopamine
Relatively normal brain configuration
Severe disruptions in early family life
Overactivity and aggressiveness in
adolescence
 Relatively good response to treatment
Table 12.5: Classifying schizophrenia on the basis of negative and positive symptoms.
Schizophrenia
 DSM-IV Subtypes:




Catatonic
Disorganized
Paranoid
Undifferentiated
Table 12.6: Types of schizophrenia described in the DSM-IV-TR.
What Causes Schizophrenia?





It has a genetic basis
It is a disease of the brain
Excess dopamine
Diathesis-stress model
Consensus that it is a complex disease of
the brain, not a “disorder of living”
Spotlight: Disorder, Race,
and Gender
 African Americans are:
 More likely to suffer from phobias and
somatoform disorders than are Caucasian
Americans
 Less likely to suffer from depression,
dysthymia, obsessive-compulsive, and antisocial personality disorder
 Less likely to seek professional help
Spotlight: Disorder, Race,
and Gender
 Asian Americans report higher incidents of
social anxiety and social phobias
 When Native Americans experience a
psychological disturbance, it is usually
depression, posttraumatic stress disorder, or
alcohol-related.
Spotlight: Disorder, Race,
and Gender
 Gender:
 Women are significantly more likely to be
diagnosed with depression
 Men are more likely to be diagnosed with
antisocial personality disorder