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Chapter 12
Psychological Disorders
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Defining and Explaining Abnormal Behavior
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Anxiety Disorders
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Mood Disorders
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Eating Disorders
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Dissociative Disorders
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Schizophrenia
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Personality Disorders
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Combating Stigma
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Abnormal Behavior
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Medically, mental illness that affects – or is
manifested in – the brain and can affect
thinking, behavior, and interaction with others
Deviant
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Maladaptive
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Atypical and culturally unacceptable
Interferes with effective functioning
Personally distressful
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Theoretical Approaches
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Biological approach
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Attributes psychological disorders to organic,
internal causes
Medical Model
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Psychological approach
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Describes psychological disorders as medical diseases
Mental illnesses . . . of patients . . . treated by doctors
Emphasizes contributions of experiences, thoughts,
emotions, and personality
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Theoretical Approaches
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Sociocultural approach
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Biopsychosocial approach
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Emphasizes social contexts in which person lives
Stresses cultural influences on understanding and
treatment of psychological disorders
Unique combinations of biological, psychological,
and sociocultural factors
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Classification Systems
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Common basis for communicating
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Can help make predictions
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May benefit person suffering from symptoms
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May also create stigma
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DSM-IV
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Classification of psychological disorders in U.S.
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DSM-IV Classification
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Diagnostic & Statistical Manual of Mental Disorders
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Published by American Psychiatric Association
DSM-IV (1994)
DSM-IV-TR (2000)
Five axes, or dimensions
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Axis I
Axis II
Axis III
Axis IV
Axis V
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Most diagnostic categories
Personality disorders & mental retardation
General medical conditions
Psychosocial and environmental problems
Current level of functioning
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DSM-IV: Critiques
Classifies individuals based on symptoms
Uses medical terminology, based on medical model
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Mental disorders in terms of disease
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Implies internal cause, relatively independent of
environmental factors
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Focuses strictly on pathology and problems
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Fails to emphasize strengths that may help reduce stigma
and maximize person’s contributions to society
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Anxiety Disorders
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Involve fears that are . . .
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Feature . . .
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Uncontrollable
Disproportionate to actual danger
Disruptive of ordinary life
Motor tension
Hyperactivity
Apprehensive expectations and thoughts
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Anxiety Disorders
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Generalized Anxiety Disorder
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Panic Disorder
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Phobic Disorders
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Obsessive-Compulsive Disorder
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Post-Traumatic Stress Disorder
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Generalized Anxiety Disorder
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Persistent anxiety for at least 6 months
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Unable to specify reasons for anxiety
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Etiology (Cause)
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Biological factors
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Psychological and sociocultural factors
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Panic Disorder
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Recurrent, sudden onsets of intense
apprehension or terror
Often occur without warning and no
specific cause
Etiology
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Biological factors
Psychological factors
Sociocultural factors
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Phobic Disorder
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Irrational, overwhelming, persistent fear
of particular object or situation
Social Phobia
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Etiology
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Intense fear of being humiliated or
embarrassed in social situations
Biological factors
Psychological factors
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Phobic Disorders: Examples
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Obsessive-Compulsive Disorder
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Obsessions
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Compulsions
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Repetitive, ritualistic behaviors
Checking, cleansing, counting
Etiology
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Recurrent, anxiety-provoking thoughts
Biological factors
Psychological factors
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Post-Traumatic Stress Disorder
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Develops through exposure to traumatic
event that overwhelms abilities to cope
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Flashbacks
Reduced ability to feel emotions
Excessive arousal
Difficulties with memory and concentration
Feelings of apprehension
Impulsive outbursts of behavior
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Post-Traumatic Stress Disorder
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Can follow trauma immediately or be delayed
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Combat and war-related traumas
Sexual abuse and assault
Natural disasters
Unnatural disasters
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Etiology
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Trauma
Other factors
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Mood Disorders
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Primary disturbance of mood, or prolonged
emotion that colors emotional state
Can include cognitive, behavioral, and
somatic (physical) symptoms
Depressive Disorders
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Major Depressive Disorder
Dysthymic Disorder
Bipolar Disorder
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Depressive Disorders
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Depression
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Major Depressive Disorder
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Unrelenting lack of pleasure in life
Significant depressive episode (five of nine symptoms)
and depressed characteristics for at least two weeks
Impaired daily functioning
Dysthymic Disorder
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More chronic and with fewer (two of six) symptoms
than major depressive disorder
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Depressive Disorders: Etiology
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Biological factors
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Psychological factors
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Learned helplessness
Cognitive explanations
Sociocultural factors
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Genetic influences
Brain structures
Neurotransmitters
Socioeconomic status (SES)
Gender differences
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Bipolar Disorder
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Extreme mood swings, including one or
more episodes of mania,
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Overexcited, unrealistically optimistic state
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Multiple cycles of depression interspersed
with mania
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Etiology
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Genetic influences
Biological processes
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Risk of Bipolar Disorder
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Suicide
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Biological factors
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Psychological factors
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Mental disorders and traumas
Substance abuse
Sociocultural factors
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Genetic factors
Neurotransmitter levels
Economic hardship
Cultural and ethnic contexts
Gender differences
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Eating Disorders
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Characterized by extreme disturbances
in eating behavior
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Anorexia Nervosa
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Bulimia Nervosa
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Binge Eating Disorder
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Anorexia Nervosa
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Relentless pursuit of thinness through
starvation
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Weighing less than 85% of normal weight
Intense fear of gaining weight
Distorted body image
Physical changes, serious complications,
and high mortality rate
Denial
High-achieving perfectionism
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Bulimia Nervosa
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Binge-and-purge eating pattern
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Preoccupation with food
Strong fear of becoming overweight
Depression or anxiety
Difficult to detect
Complications and dental problems
High perfectionism, low self-efficacy
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Anorexia & Bulimia: Etiology
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Sociocultural factors
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Biological factors
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Previously believed to be central determinants
No longer sole focus
Of increasing focus in research
Genes
Regulation of serotonin
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Binge-Eating Disorder
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Recurrent episodes of eating large amounts
of food
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Biological factors
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Genes
Dopamine
Psychological factors
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Lack of control over eating
Overweight or obese
Experience of guilt and shame
Stress
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Dissociative Disorders
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Dissociation
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Dissociative Disorders
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Psychological states of disconnection from
immediate experience
Involve sudden loss of memory or change
of identity, under extreme stress or shock
Dissociative Amnesia
Dissociative Fugue
Dissociative Identity Disorder
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Dissociative Amnesia & Fugue
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Amnesia
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Dissociative Amnesia
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Extreme memory loss caused by extensive
psychological stress
Dissociative Fugue
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Inability to recall important events
Amnesia, plus traveling away from home
and assuming new identity
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Dissociative Identity Disorder
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Formerly called multiple personality disorder
Two or more distinct personalities or selves
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Each has its own memories, behaviors, relationships
One personality dominates at one time
Wall of amnesia separates personalities
Shift between personalities occurs under distress
Exceptionally high rate of sexual or physical abuse
during early childhood
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Majority are women
Genetic predisposition may exist
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Schizophrenia
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Characterized by highly disordered thought
processes
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Positive Symptoms
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Psychotic, or far removed from reality
Marked by distortion or excess of normal function
Negative Symptoms
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Reflect social withdrawal, behavioral deficits, and
loss or decrease of normal functions
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Schizophrenia: Positive Symptoms
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Hallucinations
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Delusions
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Sensory experiences in absence of real stimuli
Often auditory
False, unusual, or magical beliefs
Not part of individual’s culture
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Schizophrenia: Positive Symptoms
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Thought Disorder
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Unusual, sometimes bizarre thought processes
Word Salad
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Neologisms
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New words
Referential Thinking
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Incoherent, loose word assocations
Ascribing personal meaning to random events
Disorders of Movement
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Catatonia
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State of immobility and unresponsiveness over time
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Schizophrenia: Symptoms
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Negative symptoms
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Flat affect
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Display of little or no emotion
Lacking ability to read emotions of others
Cognitive symptoms
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Difficulty sustaining attention
Problems holding information in memory
Inability to interpret information and make decisions
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Schizophrenia: Causes
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Biological factors
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Heredity
Structural brain abnormalities
Problems in neurotransmitter regulation
Psychological factors
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Diathesis-Stress Model
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Combination of biogenetic predisposition and stress
Sociocultural factors
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Socioeconomic level and other sociocultural factors
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Lifetime Risk of Schizophrenia
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Personality Disorders
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Chronic, maladaptive cognitive-behavioral
patterns integrate into personality
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Ten personality disorders listed in DSM-IV
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Antisocial Personality Disorder
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Borderline Personality Disorder
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Antisocial Personality Disorder
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Characterized by guiltlessness, law breaking,
exploitation of others, irresponsibility, and deceit
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Biological factors
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Genetically heritable
Brain differences
Autonomic nervous system differences
Psychopaths
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Subgroup of individuals with ASPD
Remorseless predators who engage in violence
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Borderline Personality Disorder
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Pervasive pattern of instability in . . .
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Interpersonal relationships
Self-image
Emotions
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Marked impulsivity beginning by early
adulthood and present in various contexts
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Splitting
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Thinking style characterized by seeing the world in
black and white terms
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Borderline Personality Disorder
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Potential causes are complex.
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Biological factors
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Childhood experiences
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Childhood sexual abuse
Cognitive factors
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Genetic heritability
Irrational beliefs
Hypervigilance
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Combating Stigma
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Rosenhan study (1973)
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Consequences of Stigma
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Labels of psychological disorders can be very ‘sticky’
Labels color perception of everything else person does
Prejudice and discrimination
Negative effect on physical health
Overcoming stigma
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Recognize strengths and achievements
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