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Psychological Disorders
14 Psychological Disorders
 Learning Objectives
 Chapter Outline
 Key Concepts
 Key Contributors
 Teaching the Chapter
 Lecture/Discussion Suggestions
 Classroom Activities
 Experiencing Psychology
 Critical Thinking Questions
 Vide/Media Suggestions
 References
 Sources of Biographical Information
Learning Objectives
After studying this chapter, the student should be able to:
14.1 Define psychopathology and describe the three traditional criteria for determining the presence of
psychological disorder, indicating their weaknesses. (p. 401-402)
14.2 List and describe the emphases of the six major viewpoints regarding the psychological disorders.
(p. 402-406)
14.3 Explain the nature and controversy of the insanity defense and discuss the current state of this
defense. (p. 403-404)
14.4 Explain how the DSM-IV is used as a diagnostic tool, and briefly summarize the criticisms leveled
against it, including discussion of Rosenhan’s study and Szasz arguments. (p. 406-408)
14.5 List and describe the important features of four anxiety disorders and summarize how proponents of
the six viewpoints account for the development of the anxiety disorders. (p. 408-412)
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14.6 List and describe the important features of three dissociative disorders, including proposed causes,
and mention the controversy surrounding dissociative identity disorder. (p. 412-414)
14.7 List and describe the important features of two mood disorders, including proposed causes,
emphasizing several important points about the issue of suicide. (p.415-419)
14.8 Summarize the general characteristics of all the schizophrenias and then highlight the distinctive
features of three types of schizophrenia. (p. 419-421)
14.9 Summarize how the proponents of the six viewpoints account for the development of schizophrenia,
emphasizing the findings of biopsychological researchers. (p. 421-424)
14.10 Define the term “personality disorder” and describe the important features of two such disorders,
including proposed causes. (p. 424-426)
Extended Chapter Outline
I. The Nature of Psychological Disorders
The field of psychopathology studies the nature of psychological disorders.
A. Criteria for Psychological Disorders
The main criteria for determining that a person has a psychological disorder are abnormality,
maladaptiveness, and personal distress.
1. The Criterion of Abnormality
Abnormal behavior deviates from the norm, either qualitatively or quantitatively.
2. The Criterion of Maladaptiveness
Maladaptive behavior is that which seriously disrupts one’s life.
3. The Criterion of Personal Distress
This criterion assumes that our subjective feelings of anxiety, depression, or other unpleasant
emotion determine whether we have a psychological disorder.
B. Viewpoints on Psychological Disorders
Current viewpoints attribute disorders to natural causes, but they differ in the extent to which they
attribute disorders to biological, mental, or environmental factors.
1. The Biopsychological Viewpoint
Biopsychological researchers are interested in the role of heredity, brain structure, brain
activity, and brain chemistry in the development of psychological disorders.
2. The Psychoanalytic Viewpoint
This approach studies unconscious conflicts over impulses such as sex and aggression, which
originated in childhood.
3. The Behavioral Viewpoint
This approach views disorders as stemming from positive reinforcement of inappropriate
behaviors and punishment of appropriate behaviors.
4. The Cognitive Viewpoint
According to this approach, disorders are the result of irrational or maladaptive thinking
about one’s self, life events, and the world in general.
5. The Humanistic Viewpoint
This approach views psychological disorders as the result of incongruence between one’s
actual self and public self as a consequence of trying to live up to the demands of others.
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6. The Social-Cultural Viewpoint
This approach notes that though some disorders are universal, others are unique to particular
cultures.
C. Classification of Psychological Disorders
The first modern classification system for psychological disorders was created in 1883.
1. The DSM-IV
The DSM-IV provides a means of communication among mental health practitioners, offers a
framework for research on the causes of disorders, and helps practitioners diagnose and
choose the best treatment for particular disorders.
2. Criticisms of the Diagnosis of Psychological Disorders
Some professionals criticize the potential negative effects of the diagnosis of psychological
disorders.
II. Anxiety Disorders
Though anxiety is a normal part of living, in anxiety disorders it becomes intense, chronic, and
disruptive.
A. Generalized Anxiety Disorder
The person with a generalized anxiety disorder is in a continual state of anxiety that exists
independent of any particular stressful situation.
1. The Nature of Generalized Anxiety Disorder
The central feature of this disorder is worry.
2. Causes of Generalized Anxiety Disorder
There appears to be a genetic basis to the disorder, however, each school of thought provides
a different explanation.
B. Obsessive-Compulsive Disorder
Obsessions are persistent, recurring thoughts, while compulsions are repetitive actions that one
feels compelled to perform.
1. The Nature of Obsessive-Compulsive Disorder
People whose obsessions and compulsions interfere with their daily functioning suffer from
OCD.
2. Causes of Obsessive-Compulsive Disorder
Some people appear to have a hereditary predisposition to develop OCD, however, each
school of thought provides a different explanation.
C. Panic Disorder
A panic attack is a symptom of this disorder.
1. The Nature of Panic Disorder
Panic disorder is marked by sudden attacks of overwhelming anxiety, accompanied by
dizziness, trembling, cold sweats, heart palpitations, shortness of breath, fear of dying, and
fear of going crazy.
2. Causes of Panic Disorder
There may be a genetic predisposition to developing this disorder, however, each school of
thought provides a different explanation.
D. Phobias
This refers to the experience of excessive or inappropriate fear.
1. The Nature of Phobias
Phobias are among the most common psychological disorders.
a. Specific Phobias
A specific phobia is an intense, irrational fear of a specific object of situation.
b. Social Phobia
People with a social phobia fear public scrutiny.
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c. Agoraphobia
Agoraphobia is the fear of being in public.
2. Causes of Phobias
Phobias have been the target of much scientific research.
a. Biopsychological Factors
Some people have a biological, possibly hereditary, predisposition to develop phobias.
b. Psychological Factors
Other schools of thought provide different explanations.
III. Dissociative Disorders
In dissociative disorders, the person’s conscious mind loses access to certain thoughts, feelings, and
memories.
A. Dissociative Amnesia and Fugue
Dissociative amnesia is the inability to recall personally significant memories. Dissociative fugue
is marked by memory loss characteristic of dissociative amnesia as well as the loss of one’s
identity and fleeing from one’s prior life.
1. The Nature of Dissociative Amnesia and Fugue
Dissociative amnesia is related to trauma. In dissociative fugue the person may adopt a new
identity, then emerge from the fugue state some time later.
2. Causes of Dissociative Amnesia and Fugue
Each school of thought provides a different explanation.
B. Dissociative Identity Disorder
In this disorder, a person has two or more distinct personalities that alternate with one another.
1. The Nature of Dissociative Identity Disorder
An individual’s alternate personalities might include men, women, and children, each with its
own way of walking, writing, and speaking.
2. Causes of Dissociative Identity Disorder
People who develop this disorder almost always have had traumatic experiences in early
childhood leading them to escape into their alternate personalities. Given the conflicting
evidence regarding the reality of this disorder, the existence of it promises to remain a
controversial issue for years to come.
IV. Mood Disorders
People with mood disorders experience prolonged periods of extreme depression or elation, often
unrelated to their current circumstances.
A. Major Depression
This disorder is marked by depression so intense and prolonged that the person may be unable to
function in everyday life.
1. The Nature of Major Depression
People with this disorder experience extreme distress that disrupts their lives for weeks or
months at a time.
2. Causes of Major Depression
Each of the major viewpoints offers an explanation.
a. The Biopsychological Viewpoint
Mood disorders have a biological basis, apparently influenced by heredity.
b. The Psychoanalytic Viewpoint
The classic psychoanalytic view holds that the loss of a parent of rejection by a parent
early in childhood predisposes the person to experience depression whenever she or he
suffers a personal loss later in life.
c. The Behavioral Viewpoint
One of the most influential behavioral explanations is reinforcement theory, which
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assumes that depressed people lack the social skills needed to gain reinforcement from
others and might instead provoke negative reactions from them. An influential
cognitive-behavioral theory is an attributional theory.
d. The Cognitive Viewpoint
The most influential cognitive view of depression is Beck’s cognitive theory. Another
cognitive theory focuses on rumination.
e. The Humanistic Viewpoint
This viewpoint attributes depression to the frustration of self-actualization.
f. The Social-Cultural Viewpoint
There are some cross-cultural commonalities in the manifestation of depression, but also
variability in depressive symptoms.
B. Bipolar Disorder
1. The Nature of Bipolar Disorder
This is characterized by periods of mania alternating with longer periods of major
depression.
2. Causes of Bipolar Disorder
Heredity plays a role.
C. Suicide and Mood Disorders
Most suicides are associated with major depression.
V. Schizophrenia
Schizophrenia is a severe psychological disorder characterized by impaired social, emotional,
cognitive, and perceptual functioning.
A. The Nature of Schizophrenia
About 1% of the world’s population are victims of schizophrenia.
1. Characteristics of Schizophrenia
Schizophrenia is associated with sensory-perceptual, cognitive, social-emotional, and motor
symptoms.
a. Sensory-Perceptual Symptoms
People with schizophrenia typically experience hallucinations.
b. Cognitive symptoms
Chief among the cognitive symptoms is difficulty with attention. Among the most
distinctive cognitive disturbances are delusions.
c. Social-Emotional Symptoms
Schizophrenic people typically have flat or inappropriate emotionality.
d. Motor Symptoms
Schizophrenia is also associated with unusual motor behavior.
2. Kinds of Schizophrenia
Diagnosticians distinguish several kinds of schizophrenic disorders: Disorganized, catatonic,
and paranoid.
B. Causes of Schizophrenia
No single viewpoint can explain all cases.
1. The Biopsychological Viewpoint
Biopsychological theories of schizophrenia consider genetic, biochemical, and neurological
factors.
a. Hereditary Factors
Though there is a strong hereditary basis for schizophrenia, it seems that schizophrenia is
best explained by the diathesis-stress model.
b. Neurochemical Factors
There is evidence of a dopamine basis for schizophrenia.
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c. Season-of-Birth Factors
A disproportionate number of victims are born in November, December, and January.
d. Neurological Factors
Brain-imaging studies have shown that schizophrenia is often associated with unusual
brain activity.
2. The Psychoanalytic Viewpoint
According to this viewpoint, people who become schizophrenic fail to overcome their
dependence on their mothers and, as a result, become fixated at the oral stage.
3. The Behavioral Viewpoint
Behavioral theories assume that schizophrenics are rewarded for behaving in bizarre ways.
4. The Cognitive Viewpoint
Proponents of the cognitive viewpoint point to disturbances of attention and thinking as the
main factors in schizophrenia.
5. The Humanistic Viewpoint
According to the humanistic viewpoint, schizophrenia reflects extreme incongruence between
the public self and the actual self.
6. The Social-Cultural Viewpoint
Cultural factors can affect the precise pattern of symptoms in schizophrenia, but there is
some cross-cultural universality in schizophrenic symptoms.
VI. Personality Disorders
Personality disorders are long-standing inflexible, maladaptive patterns of behavior.
A. Borderline Personality Disorder
BPD has been of growing interest because it has become more prevalent, devastates the lives of
its victims and their loved ones, and presents one of the greatest challenges to therapists.
1. The Nature of Borderline Personality Disorder
The hallmark symptoms include impulsivity, unstable moods, and inconsistent sense of
identity, and difficulty maintaining fulfilling intimate relationships.
2. Causes of Borderline Personality Disorder
There is a strong relationship between BPD and sexual abuse.
B. The Antisocial Personality Disorder
This disorder has been of particular interest perhaps because of it has been implicated in many
notorious criminal cases.
1. The Nature of Antisocial Personality Disorder
This disorder is marked by impulsive, manipulative, often criminal behavior, without any
feelings of guilt in the perpetrator.
2. Causes of the Antisocial Personality Disorder
Research has suggested a genetic basis; people with antisocial personalities have unusually
low levels of reactivity to stress.
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Key Concepts
The Nature of Psychological
Disorders
diathesis-stress model
insanity
neurosis
psychopathology
psychosis
Anxiety Disorders
agoraphobia
anxiety disorder
generalized anxiety disorder
obsessive-compulsive disorder
panic disorder
phobia
specific phobia
social phobia
mood disorder
seasonal affective disorder
(SAD)
Dissociative Disorder
dissociative disorder
dissociative fugue
dissociative identity disorder
dissociative amnesia
Schizophrenia
catatonic schizophrenia
disorganized schizophrenia
paranoid schizophrenia
schizophrenia
Mood Disorders
bipolar disorder
major depression
mania
Personality Disorders
antisocial personality
disorder
borderline personality
disorder
personality disorder
Robert Spitzer
Thomas Szasz
Susan Nolen-Hoeksema
Norman Rosenthal
Edwin Shneidman
Key Contributors
The Nature of Psychological
Disorders
Albert Bandura
Sigmund Freud
Hippocrates
Emil Kraepelin
Abraham Maslow
Carl Rogers
David Rosenhan
B.F. Skinner
Anxiety Disorders
Samuel Turner
Schizophrenia
Nancy Andreasen
R.D. Laing
Mood Disorders
Lauren Alloy
Aaron Beck
Peter Lewinsohn
Personality Disorders
Robert Hare
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Teaching the Chapter
The material on abnormal behavior typically holds great fascination for introductory psychology students.
They are, however, apt to feel overwhelmed by the amount of new terminology. Students generally find a
discussion of the differences between the terms insane and psychotic to be interesting and important. Also,
note that “abnormal” is a relative term, with social, political, and economic implications; behaviors viewed
as abnormal at one time in history, or within a certain culture or society, may not be so viewed today in the
United States or Canada. Also, the behavior performed by some members of our society may be labeled
“psychotic” while the same behavior performed by others may be merely “eccentric.”
Students may also find it helpful if you outline the various disorders discussed in the chapter. Bringing a
copy of the DSM to class is interesting and relevant and may help students to see the big picture. Discuss
how DSM-IV differs from DSM-III. Ask the class to suggest reasons for the changes.
For many students, when they think of a psychological disorder, they imagine “crazy” people depicted as
fictional characters on television or film. To counter this view, showing videos of real people with
psychological disorders helps students to see that people with disorders are human.
There are two phenomena to be cognizant of in teaching this chapter. First, there is the likelihood that you
will have in your class a student (perhaps several) who is currently (or has been recently) involved in a
personal situation with someone exhibiting symptoms of a mental disorder. The need to balance the class’s
right to information with an individual’s right to be emotionally protected is not easy. Being up-front with
the students at the introduction of this chapter helps. Tell students that if they are in such a situation and
they feel that discussing the information in class will be too painful, they can choose to do the work outside
of class. Be sure to tell the students about whatever counseling services you have on campus. This is a
good time to have someone from the counseling center make a presentation aimed at student problems with
adjustment to college and some of the possible solutions.
When studying abnormal behavior, we tend to look more closely at our own behavior, and students will
express fears that they may be suffering from some form of psychological disorder. In most cases, the
students will be affected with the “medical student syndrome,” the tendency to attribute to themselves the
symptoms they are currently learning about. Students will see themselves and people close to them in the
descriptions of abnormal behavior. Reassure them that everyone exhibits what could be classified as
abnormal behavior at one time or another. “Strange” behaviors become a problem only when they interfere
with adaptive functioning.
Lecture/Discussion Suggestions
1.
Speculating about the Causes of Abnormal Behavior. Many introductory psychology texts
introduce abnormal psychology by discussing the supernatural model, and then discuss Galen (second
century C.E.) and his imbalance of humors as a prototype of the biochemical model. The very same
model was noted in India centuries before Galen. In the system of medicine known as Aayurveda,
traced to a collection of hymns known as the Atharvaveda (circa 1000 B.C.E.) Atharvana Rishi
proposed a holistic view of illness. He ascribed different causes to different illnesses, ranging from
climactic conditions (i.e., lightning) as the cause of colds and fever, to the uttering of falsehoods as the
cause of dropsy (Bloomfield, 1969).
Although there are many current views and models of abnormal behavior, cross-cultural and
cross-national research seems to support the diathesis-stress model of abnormal behavior. Diathesis
suggests a biological predisposition, and, according to this model, some stressful event interacts with
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the biological predisposition to produce abnormal behavior. As far back as 1955, researchers had
observed the effect of migration on mental health. The consequences of immigration appear more
severely in second generation immigrants (Zaidi, 1981).
Bloomfield, M. (1969). Hymns of the Atharvaveda. New York: Greenwood Press.
Zaida, S. M. H. (1981). Peasants in cities: Assimilation of rural migrants into city culture. In J.
L. M. Binnie-Dawson, G.H. Blowers, & R. Hoosain (Eds.). Perspectives in Asian CrossCultural Psychology. Lisse: Swets & Zeitlinger.
2.
Children and Panic Disorders. According to psychiatrist Donna Moreau and her colleagues at the
New York State Psychiatric Institute, children as young as 5 years old suffer from panic disorder. In a
study of 220 children and their mothers tracked over 2 years, six children, ranging in age from 5 to 18
were found to have panic disorder. These children had at least one parent who suffered severe
depression or panic disorder. Furthermore, each of the youngsters had several other disorders, such as
phobias and intense separation anxiety.
Bower, B. (1988, May 21). An early start for panic. Science News, 133 (21).
3.
Loneliness and Depression. The connection between loneliness and depression is intuitively obvious;
however, the magnitude of the problem is not. One national study suggests that as many as 26% of
Americans report being very lonely or removed from others. Also, many students are surprised (often
pleasantly, since they don’t feel so weird) to find that it is the young and not the elderly who are more
often lonely. Not surprisingly, married persons report less loneliness, and separated, divorced, or
widowed persons are most lonely. Interestingly, choiceful singleness, including those who “just never
married,” do not report being more lonely than the general population.
Brehm reports that gender does affect loneliness, but interactively rather than directly. For example,
married females report a higher level of loneliness than do married males, whereas males report
greater loneliness in the following situations: those who never married, those whose spouse has died,
and those who are separated or divorced. Specifically, Brehm believes that men and women differ in
their vulnerability to two different types of loneliness. Since marriage is more likely to reduce a
woman’s social network than a male’s, women report a lack of a network of friends and acquaintances
(social isolation) as being more loneliness-inducing, whereas men seem more responsive to the loss of
a single intense relationship (emotional isolation).
The reasons given for being lonely generally fall into one of five categories: (1) unattached, no spouse
or sexual partner; (2) alienated, feeling misunderstood or different; (3) being alone, the “empty house”
feeling; (4) forced isolation, hospitalization or housebound due to a lack of transportation; and (5)
dislocation, being in a new situation without or outside of social support systems. Likewise people
cope differently. Coping strategies tend to fall into one of four categories: (1) sad passivity, such as
sleeping, overeating, watching TV, etc.; (2) social contact, involves setting up social situations; (3)
active solitude, studying, reading, exercise, etc.; or (4) distractions, spending large sums of money,
etc.
Brehm, S. (1985). Intimate relationships. New York: Random House.
4.
Depressive Realism. One surprising aspect of depression is the fact that persons who are happy or
optimistic are less accurate in their ratings of certain events than are those who are depressed. Alloy
and Abrahamson first identified this in 1979, initially labeling it the sadder-but-wiser effect.
Alloy and Abrahamson originally wanted to test the learned helplessness theory of depression. They
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recruited groups of depressed and nondepressed persons. The subjects were then, one at a time,
placed behind a series of lights and buttons. At specified intervals, they were given a choice of
whether or not to push one of the buttons. A light came on every other button-pressing choice,
whether they pressed or not. The participants were asked at the end of the study to estimate their
control over the light. From the helplessness theory, it was predicted that the depressed would do
worse at the tasks. Surprisingly, the depressed persons were very accurate, whereas the nondepressed
grossly overestimated their degree of control over the light.
Several other studies have been done by Alloy and Abrahamson to reexamine these results. The
studies have shown that nondepressed people consistently overestimate their control over positive
events and underestimate their control over negative events.
Hapgood, F. (1985, August). The sadder-but-wiser effect. Science, 85, 86–88.
5.
Conversion/Somatoform Disorders. Hand-glove anesthesia is the most common example of
conversion or somatoform disorder. One explanation is that people somatize their psychological pain
by creating maladies that are supported by their belief systems. As a result, there are many
culture-bound somatoform disorders. In some cultures, it is not considered acceptable for people to
feel sad or depressed; when they ARE depressed, they somatize their symptoms in culturally
acceptable ways.
Dr. Keh-ming Lin (1983) reports the case of Mrs. B, who was born in Korea. Mrs. B had lived in the
U.S. for five years when she came to a health clinic. She complained of sensitivity to cold, severe
fatigue, and a mass in her abdomen, which was putting pressure on her chest. She feared that the “fire
was coming up to her throat” and that she would choke to death. Sensitivity to cold led her to wear
heavy clothing, even in the summer. She stayed at home often, keeping her house very warm. The
symptom that brought her to the clinic was the fist-sized mass in her abdomen–the Hwa-byung,
which she claimed moved up and down in her body. Sometimes it caused dyspnea, sometimes
diarrhea, and at times, constipation. It always caused epigastric pain, because the Hwa-byung
generally resided in the epigastrium.
Mrs. B’s physician recognized the situation as a somatoform disorder. In talking about her life, Mrs.
B revealed that, several years prior to the onset of the problem, while living in Korea, she had
divorced her husband. It had been an arranged marriage, and after several years, she needed to get
out of the marriage. As a consequence of the divorce, she lost custody of her child, and, rather than
live in Korea with the shame of divorce, she left Korea and moved to the United States.
Mrs. B’s family was achievement-oriented, and Mrs. B had not been very successful in the U.S.
Eventually, she met and moved in with another Korean man. Although he was not a stabilizing
influence, she preferred being with him to being lonely. The guilt of having left her child back in
Korea had always troubled her, but things intensified when the man with whom she was now living
threatened to move out. It was then that the anger and resentment turned into the “ball” that dribbled
on its own inside her. Mrs. B was put on tricyclic antidepressant and was encouraged to take
continuing education classes to learn spoken English. Eventually, her Hwa-byung dissolved.
According to traditional Korean medicine, the heat of swallowed anger (anger which is not
expressed) causes the Hwa-byung. In Korea, there are all kinds of herbal medicines and folk
remedies for dissolving the non-existent mass. However, in the United States, when Koreans seek
help for the Hwa-byung, they are either not helped, or they are given unnecessary diagnostic tests.
Occasionally, patients even demand surgery.
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Lin K. (1983). Hwa-yung: A Korean culture-bound syndrome? American Journal of Psychiatry,
140 (1).
6. Pros and Cons of the Insanity Defense. The use of the insanity defense is bound to stimulate a
spirited class discussion. Be sure to include the following pros and cons in your discussion:
Pro
 The NGRI (not guilty by reason of insanity) plea is rarely entered and even more rarely accepted.
It is, therefore, not just a loophole.
 Doing away with the NGRI means that information about a person’s mental health (or illness in
this case) would be inadmissable or meaningless.
 Surely experts disagree; this does not mean the very strategy is wrong. Judges and juries are
capable of making informed decisions about the credentials, etc. Judges and juries are responsible
for evaluating expert testimony and deciding whether the defendant is guilty or not.
 If NGRI were replaced with “guilty, but mentally ill,” the defendant would have no assurance of
adequate psychological supervision while in prison.
 It is in no way constitutional (because it would be inhumane) to punish an insane person in the
same way as a sane person.
Con
 NGRI is nothing but a legal loophole for guilty clients and their lawyers.
 Psychologists and/or psychiatrists should be excluded from the courtroom as experts since they
have no legal expertise.
 Juries are often left confused by the disagreement of “expert” psychological witnesses.
 Psychological data should be excluded from the courts until such time as they can be standardized.
 Society should be protected from all criminals whether sane or insane, and only a guilty verdict
does this.
 The “guilty, but mentally ill” verdict would protect society and provide psychological services to
the guilty defendant.
7.
Attention-Deficit Hyperactivity Disorder. This disorder has received a lot of media attention in
recent years, so students may be interested in hearing more about it.
The disorder has been diagnosed since the 1940s under various labels. There is still confusion
among researchers and practitioners as to what criteria should be used in diagnosis, and the cause is
still debated. Recent research suggests that there is a genetic component to the disorder that causes a
lack of self-control. Symptoms may appear at any age, but typically between ages of 3 and 5. Boys
are three times as likely to be diagnosed with the disorder than girls are. Cross-cultural research has
found the disorder in “every nation and culture they have studied.”
Since the disorder was seen as an attention problem, it was thought that the individual was being
overwhelmed by sensory input. Recent research suggests the problem lies in the ability to control
motor response instead.
Brain imaging reveals involvement of the prefrontal cortex, the cerebellum, and the basal ganglia.
These areas are important in regulating attention. What causes shrinkage of these areas is still
unknown, but it appears that genetic mutations may play a role. It is currently thought that ADHD is
a polygenic disorder.
Non-genetic factors also play a role in the development of the disorder: “premature birth, maternal
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alcohol and tobacco use, exposure to high levels of lead in early childhood and brain injuries —
especially those that involve the prefrontal cortex.” Diet and childrearing practices are not related to
ADHD.
As people develop, they internalize the executive functions:
 Working memory
 Self-directed speech
 Controlling emotions
 Reconstitution: “breaking down observed behaviors and combining the parts into new
actions not previously learned from experience.”
Russell Barkley, from the University of Massachusetts Medical Center, suggests that those diagnosed
with ADHD haven’t been able to internalize those executive functions so they manifest as public
behavior.
Barkley, R. A. (Sept, 1998). Attention-Deficit Hyperactivity Disorder. Scientific American.
Retrieved April 8, 2001, from the World Wide Web:
http://www.sciam.com/1998/0998issue/0998barkley.html
Classroom Activities
1.
Institutionalization. When someone who has committed a criminal act is deemed insane, the person
is confined in a psychiatric institution where the individual’s case comes up for periodic review. It is
up to the institution’s review board to determine when and if the person may be released.
Have your students form groups. Ask them to imagine that they are such a review board, and present
them with this fictional case:
John Doe, suffering from delusions of persecution resulting from his schizophrenia, killed the man
who kept coming to his house – same time, six days a week. John believed this man to be a threat to
his family. One day, John killed his postal carrier. He believed he was protecting his family. The
jury found him insane. It has taken some time to find the right kind and dosage of antipsychotic
medication since he was institutionalized 5 years ago, immediately following his arrest. John has
been symptom-free with his current medication for 12 months.
Each group, acting as a review board, is to decide whether John Doe will be released. What
information is important in making that decision? What additional information would they like to
have, and how would that inform their decision?
Bring the class back together and have each group report on their deliberations.
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Experiencing Psychology: How do the media portray psychological disorders?
Rationale
Psychological disorders are a favorite topic of the media. You cannot go a day without reading about them
in a magazine or newspaper, seeing people with disorders on daytime talk shows and soap operas, hearing
about them on radio talk shows, or watching reports on them on the nightly television news. This activity
asks you to keep a record of media portrayals of psychological disorders.
Procedure
Keep a two-week diary of every instance in which you encounter a media portrayal of a person with a
psychological disorder. Note such instances in movies, on radio or television, and in books, magazines, or
newspapers. Also note how often particular topics or disorders are presented and whether they are
portrayed in a casual, scientific, or sensational manner.
Results and Discussion
Discuss your impression of how the media portrays psychological disorders. How does the information
presented in the media compare with the information presented in this chapter? What should the media
present concerning psychological disorders that it does not do well enough?
Critical Thinking Questions
1.
Generate three examples of behaviors that are considered normal for men and abnormal for women.
Discuss the basis for the designation of normal vs. abnormal in each example.
2.
Could biological, psychological, and sociocultural theories of abnormal behavior all be correct?
Explain your answer.
3.
In some cultures it is a positive characteristic to have the ability to communicate with a deceased
member of the family. Compare this to the definitions of hallucination and delusion in our text and
discuss the implications for diagnosis and treatment.
4.
How would a social learning theorist account for a phobic fear of dogs? How might a psychoanalyst
account for the same phobia?
5.
The various forms of schizophrenia are quite different. What do they have in common? Why are they
all considered schizophrenia?
6.
Why do you think that personality disorders are generally very difficult to treat?
7.
A friend who knows you’re taking a psychology class says to you, “I think Larry is schizophrenic or
something. Sometimes when I see him he’s friendly and warm, but other times he’s mean and nasty.”
How would you respond to your friend?
8.
Many of us have seen an individual walking down the street, clad in a heavy sweater or jacket on the
hottest summer day, busily talking or yelling to himself. Seeing this individual makes many of us feel
uncomfortable, but raises some fundamental public policy issues. How much nonconforming
behavior should our society tolerate? What are the limits of free speech and nonconforming
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behavior?
9.
To what extent does our society view individuals as being responsible for their mental states?
Provide evidence for your answer.
10. When should an individual be placed in a mental institution at public expense? Should it matter
whether or not the individual consents to be institutionalized?
11. Based on what you’ve learned in this course so far, why do you think most people feel uncomfortable
interacting with someone who is exhibiting symptoms of a psychological disorder, such as
schizophrenia?
Video/Media Suggestions
Anxiety Disorders (Insight Media, 1992, 60 minutes) Examining two common disorders — panic with
agoraphobia and generalized anxiety disorder — this program from The World of Abnormal
Psychology investigates causes and treatments of anxiety disorders. From Annenberg/ CPB.
Depression and manic depression (Insight Media, 1996, 28 minutes) Explaining that many cases of
clinical depression remain untreated due to issues of stigma and fear, this video explores the
relationship between untreated depression and suicide, using as examples the depressions of such wellknown public figures as Mike Wallace and Kay Redfield Jamison. It also provides an overview of
medications and forms of therapy for depression.
Discovering psychology 21: Psychopathology (Annenberg/CPB Project, 1990, 30 minutes, color)
Examines the major mental disorders and discusses the biological and psychological factors that
influence them.
Exploring social anxiety disorder (Insight Media, 1998, 60 minutes) Explaining how to detect the
symptoms of social anxiety disorder, this program details rationales for various pharmacologic
therapies. It presents video clips of actual patients, features a virtual roundtable of leading experts, and
uses animation to clarify complex concepts. It also discusses recent evidence that suggests that the
SSRIs may be effective agents in treating social anxiety disorder.
Extending the boundaries of the treatment for panic (Insight Media, 1999, 90 minutes) Panic disorder is
relatively common; left untreated, it can cause progressive restriction in the professional and personal
lives of sufferers. Explaining that the clinical goals of treatment are alleviation of attacks and relief of
such symptoms as agoraphobia, anticipatory anxiety, and phobic avoidance, this video reviews
effective treatment strategies. It assesses the relative benefits of pharmacotherapy, cognitive
behavioral therapy, and combined regimens. HSTN.
Hope and solutions for OCD (Insight Media, 1999, 85 minutes) Designed for health professionals, school
personnel, and the families of individuals who suffer from obsessive-compulsive disorder, this program
provides basic information about OCD and its treatment. It explains what the disorder is, how it can
affect the performance of daily tasks and interpersonal relations, and the most effective ways to treat it.
I‘m still here: The truth about schizophrenia (Insight Media, 1996, 67 minutes) In this video, medical
professionals debunk the myths of schizophrenia to provide an accurate and comprehensive picture of a
complex disease. The program offers examples of individuals who, though afflicted by this illness, lead
lives of extraordinary accomplishment.
The lingering fallout of violence: Post-traumatic stress disorder (Insight Media, 1999, 90 minutes)
Approximately 8% of the general population is diagnosed with PTSD, but more probably suffer from it
as the diagnosis is often missed. Patients with PTSD suffer significant impairment in interpersonal and
professional relationships. This video discusses the presentation and diagnostic criteria for PTSD and
explores treatment options that enhance patient outcomes. HSTN.
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Psychological Disorders
Losing the thread: The experience of psychosis (Insight Media, 1992, 54 minutes) A portrait of a woman
who has suffered from psychosis for 25 years. The subject explains how it feels to experience a
psychotic episode, illuminating why she loses her ability to recognize friends, and why simple objects
can be menacing.
Manic (Filmmakers Library, 1993, 47 minutes) A docu-drama depicting an individual’s struggle with
bipolar disorder and its impact on family and friends.
The many faces of Marsha (Insight Media, 1991, 48 minutes) This 48 Hours program illuminates the
mysteries of multiple personality disorder through the cases of one woman trapped in a maze of more
than 200 personalities.
OCD (Insight Media, 1993, 41 minutes) This video profiles several people who suffer from varying
degrees of obsessive-compulsive disorder, showing how extreme cases can disrupt normal functioning.
Marvin Karno provides an introduction to the disorder.
Personality disorders (Annenberg/CPB Project, 1992, 60 minutes) From the series “World of Abnormal
Psychology,” this video identifies 11 personality disorders and focuses on the following four:
narcissistic, antisocial, borderline, and obsessive-compulsive.
Schizophrenia: The voices within/The community without (Films for the Humanities and Sciences, 1990,
19 minutes) This video introduces several important aspects of schizophrenia: symptoms, medications,
and the deinstitutionalization of patients.
Trouble in mind (Insight Media, 1999, 13 volumes, 30 minutes each) This set focuses on 13 common
mental disorders, discussing typical behavior and symptoms and how to spot and interpret symptoms.
The disorders include Alzheimer's disease, antisocial personality disorder, ADHD, bipolar disorder,
delirium, depression, eating disorder, obsessive-compulsive disorder, panic disorder, PTSD,
postpartum depression, psychosomatic disorder, and schizophrenia.
Women and depression (Insight Media, 2000, 28 minutes) Clinical depression affects 19 million
Americans, two thirds of whom are women. This video explains how to recognize symptoms of
depression, discusses methods for treating it, and presents interviews with women who discuss their
personal experiences with depression.
Please note: Films for the Humanities and Sciences has a catalog detailing many programs devoted to
various aspects of abnormal behavior. Among the newer entries is the 1996 six-program series entitled
Anxiety-Related Disorders: The Worried Well, and the 1994 three-program series entitled Diagnosis
According to the DSM-IV. To review the available films, visit http://www.films.com.
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References
Andreasen, N. C. (1994). Schizophrenia: From mind to molecule. Washington, DC: American
Psychiatric Press.
Backlar, P. & Andreasen, N. C. (1995). The family face of schizophrenia: True stories of mental illness
with practical counsel from America’s leading experts. New York: Putnam.
Beidel, D. C. & Turner, S. M. (1998). Shy children, phobic adults: Nature and treatment of social
phobia. Washington, DC: American Psychological Association.
Frances, A. & Ross, R. (1996). DSM-IV case studies: A clinical guide to differential diagnosis.
Washington, DC: American Psychiatric Press.
Hare, R. (1999). Without conscience: The disturbing world of the psychopaths among us. New York:
Guilford Press.
Marneros, A., & Andreasen, N. C. (1995). Psychotic continuum. New York: Springer-Verlag.
Nolen-Hoeksema, S. (1990). Sex differences in depression. Stanford, CA: Stanford University Press.
Rosenthal, N. E. (1998). Winter blues: Seasonal affective disorder: What it is and how to overcome it.
New York: Guilford Press.
Shneidman, E. S. (2001). Comprehending suicide: Landmarks in 20th-century suicidology. Washington,
DC: American Psychological Association.
Spitzer, R. L., Gibbon, M., Skodol, A.E., & First, M.B. (Eds.) (1994). DSM-IV casebook: A learning
companion to the Diagnostic and Statistical Manual of Mental Disorders, 4 th ed. Washington, DC:
American Psychiatric Press.
Szasz, T. S. (1997). Insanity: The idea and its consequences. New York: Syracuse University Press.
Sources of Biographical Information
Beers, C. W. (1908/1981). A mind that found itself. Pittsburgh: University of Pittsburgh Press.
Burrow, T. (1958/1979). A search for man’s sanity: The selected letters of Trigant Burrow with
biographical notes. Salem, NH: Ayer.
Dain, N. (1980). Clifford Beers: Advocate for the insane. Pittsburgh: University of Pittsburgh Press.
Laing, R. D. (1985). Wisdom, madness, and folly: The making of a psychiatrist. New York: McGrawHill.
Mullan, B. & Laing, R. D. (1995). Mad to be normal: Conversations with R. D. Laing. London: Free
Association Books.
Pachter, H. M. (1951). Magic into science: The story of Paracelsus. New York: Harry Schuman.
Russell, R. & Laing, R. D. (1992). R..D. Laing and me: Lessons in love. Lake Placid, NY: Hillgarth
Press.
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