Download Ch. 16 Psychological Disorders

What is abnormal behavior? What is meant by a
psychological disorder?
A “harmful dysfunction” judged to be:
 Atypical – outside of norms
 Disturbing - varies with time and culture
 Maladaptive
 Harmful
 Unjustifiable
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Defining abnormality
› Subjective discomfort
› Statistical definitions
› Social non-conformity
› Situational context
› Cultural relativity (all definitions of abnormality are relative)
› It is generally agreed that behavior must interfere with normal
activities and cause distress to be abnormal; behavior must be
“maladaptive,” not meeting demands of day to day life (e.g.,
danger to self and/or others)

Psychopathology: the scientific study of
mental, emotional, and behavioral
disorders, e.g.
› An inability to behave in ways that foster the
well-being of the individual and, ultimately,
society
› Good “mental health” implies getting what you
want to be socially acceptable.

Mental health problems are extensive
› 1 in 100 will require hospitalization
› In any given week, 13% of Americans
experience an anxiety-related disorder.
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DSM-IV
› American Psychiatric Association’s Diagnostic
and Statistical Manual of Mental Disorders
(Fourth Edition, 1994). Presently distributed as
DSM-IVR (revised 2000)
› Widely used system for classifying
psychological disorders. Seventeen major
categories, 5 axes

Disorders usually diagnosed in infancy,
childhood, or adolescence.
› ADD, mental retardation, stuttering, etc..

Delirium, dementia, and other cognitive
disorders.
› Memory and thought distortion as a result of
brain damage (Alzheimer’s Disease)

Substance related disorders
› Alcohol and drugs

Psychotic disorders
› characterized by a retreat from reality, by
hallucinations and delusions, and by social
withdrawal; psychotic person cannot tell fantasy
from hallucination from reality [e.g.,
schizophrenia (probably a disorder of the frontal
cortex); delusional disorders; severe mood
disorders.

Mood Disorders
› disturbances in affect or emotion (e.g., manic or
depressed in “manic-depressive” or “bi-polar”
disorder); may include psychotic symptoms

Anxiety Disorders
› panic, phobias, or generalized anxiety
[neurosis; chronic and persistent anxiety;
post-traumatic stress disorder (PTSD: anxiety
existing after a distressing or traumatic
event); obsessive (thoughts)-compulsive
(acts) disorder (OCD)]

Somatoform Disorders
› physical symptoms that mimic physical
disease or injury for which there is no
apparent cause (e.g., hypochondriasis;
conversion reactions)

Dissociative Disorders
› sudden amnesia; multiple personality;
depersonalization

Sexual and Gender-Identity Disorders
› gender identity disorder; paraphilias
[exhibitionism, fetishism, voyeurism; also, sexual
dysfunction (N.B. rape a crime not a sexual
disorder; homosexuality no longer considered a
sexual disorder)]

Eating Disorders
› Anorexia nervosa, bulimia nervosa

Sleeping Disorders
› Insomnia, sleepwalking, narcolepsy

Impulse Control Disorder
› Tendency to act on impulses, such as
gamble excessively or steal

Axis I – used to classify current symptoms;
Range from disorders that are first evident
during Infancy, childhood, or adolescents
to substance-abuse disorders to
schizophrenia.

Axis II – describes developmental disorders
and long-standing personality disorders,
such as compulsiveness, over-dependency,
or aggressiveness; language disorders,
reading or writing difficulties, autism, or
speech problems.

Axis III – describes physical disorders or
general medical conditions that are
relevant to understanding or caring for a
person; brain damage, chemical
imbalance that causes a disorder in Axis I.

Axis IV – measurement of current stress level
at which the person is functioning. Stress is
rated on events that have occurred within
the past year.

Axis V – highest level of adaptive functioning
present within the past year.

Adaptive functioning means
› Social relation- quality of relationship with friends and
family.
› Operational functioning- how you function as a worker,
student, or homemaker and the quality of work you
accomplish.
› Use of leisure time- recreational activities or hobbies and
the amount of involvement and pleasure a person has
from them.

Anxiety – vague, generalized apprehension or
feeling one is in danger.
Any disorder in which anxiety is a characteristic
feature or avoidance of anxiety motivates
abnormal behavior
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Generalized Anxiety Disorder
Panic Disorder
Specific Phobia
Social phobia
Obsessive-Compulsive Disorder (OCD)
Post-traumatic stress disorder (PTSD) v. acute stress disorder

Phobia – intense and irrational fear of a
particular object or situation.

Panic disorder – an extreme anxiety that
manifests itself in the form of panic attacks.

Symptoms include sense of smothering,
choking, or difficulty breathing; faintness or
dizziness; nausea; and chest pains.

Obsessive-Compulsive Disorder (OCD) –
acute anxiety that cause a person to think
the same thoughts over and over again.

Examples??

Why do people develop OCD?
› Possibly used as a diversion from real fears and
help reduce anxiety.
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Conditioning
Feelings of not being in
control
Genetic predisposition
to some anxiety
disorders
Displacement or
repression of
unacceptable
thoughts or impulses
Societal or social
pressures

Post-traumatic stress disorder – victims of
traumatic events who experience the
original event in the form of flashbacks or
dreams.

Examples??
Physical symptoms without any physical
cause.
Person experiences symptoms as real
› Somatization disorder
› Hypochondriasis
› Conversion disorder (hysteria)
 La belle indifference
› Factitious disorders
› Body dysmorphic disorder http://www.youtube.com/watch?v=iAuc2xAM7-8
Freud
› Symptoms related to traumatic experience in
the past
Cognitive-Social
› Ways in which the behavior is being rewarded
Biological perspective
› Real physical illnesses that may be misdiagnosed
or overlooked
Conscious awareness becomes separated
(dissociated) from previous memories,
thoughts, and feelings

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Dissociative Identity Disorder (formerly MPD)
Dissociative amnesia
› Anterograde v. retrograde
› Malingering

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Dissociative fugue
Depersonalization disorder
May involve unconscious processes
 Memory impairments may also include
biological factors such as normal aging
and Alzheimer’s disease
 Common with use of some drugs such as
LSD
 Trauma may also be involved

A group of severe disorders characterized
by
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disorganized and delusional thinking
delusions of
reference/persecution/grandeur
disturbed perceptions/hallucinations
(auditory) and disorganized thought
inappropriate emotions and actions
blunting/flat or inappropriate affect
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Paranoid
Disorganized (hebephrenic)
Undifferentiated
Residual
Catatonic
› Wavy flexibility and mutism
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Biological predisposition
Twin studies show genetic link
Excessive levels of dopamine lead to
symptoms
Abnormalities of brain structures
Abnormal patterns of connections between
brain cells
May involve family relationships and social
class
Environmental triggers
Disorders characterized by inflexible and
enduring behavior patterns that impair
social functioning (inflexible and maladaptive)
Antisocial personality disorder
Dependent personality disorder
Histrionic personality disorder
Borderline personality disorder
Schizoid personality disorder
Narcissistic personality disorder
Passive-aggressive personality disorder
Avoidant personality disorder
Paranoid personality disorder
Combination of biological predisposition,
adverse psychological experiences, and
an unhealthy social environment
 Also possible link to damaged frontal
lobe during infancy
 Emotional deprivation during childhood
may lead to antisocial tendencies
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Major Depressive disorder – severe form
of lowered mood in which a person
experiences feelings of worthlessness
and diminished pleasure or interest in
many activities.

Seasonal Affective Disorder (SAD)

More that 30,000 Americans a year end
their lives due to depression.

Personality disorders: inflexible ways of
dealing with others and one’s
environment.
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Anti-social personality: irresponsible,
shallow emotions, and lack of
conscience.
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Antisocial
› Patterns of disregard and violating the rights of
others without feeling remorse.
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Dependent
› Patterns of submissiveness and excessive need
to be taken care of.
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Histrionic
› Excessive emotion; constantly seeking attention
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Obsessive-Compulsive
› Intense interest in being orderly; having control,
and achieving perfection
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Paranoid
› Distrusts others; perceives others as having evil
motives.
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Schizotypal
› Feeling of intense discomfort in close
relationships; distorted thinking and eccentric
behavior.
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Psychological dependence: use of a drug
to such an extent that a person feels
nervous of anxious without it.
› Alcohol
› Nicotine
› caffeine

Addiction: pattern of drug abuse
characterized by an overwhelming and
compulsive desire to obtain and use the
drug.

Tolerance: physical adaptation to a drug so that a
person needs an increased amount in order to
produce the original effect.

Withdrawal: state of physical and physiological
upset during which the body and mind revolt
against the absence of the drug.
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Nausea
Shakes
Hallucinations
Migraines
Convulsions
Death
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Most severe drug
addiction in the United
States.
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http://www.sadd.org/s
tats.htm#underage
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Alcohol can cause
psychological
dependence,
tolerance, and
addiction.

Alcoholism
develops from both
environmental and
genetic factors.

A person’s risk of
becoming an
alcoholic is three to
four times higher if
a family member is
an alcoholic.

Step 1: Get help through delirium
tremens (violent withdrawal)

Step Two: Get treatment
› Alcoholics Anonymous (AA)
› Drug therapy
› Psychotherapy
› Hypnosis