Psychological Disorders

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• Chapter 15
• Psychological Disorders

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Chapter Preview

• Defining/Explaining Abnormal Behavior
• Anxiety Disorders
• Mood Disorders
• Dissociative Disorders
• Schizophrenia
• Personality Disorders
• Psychological Disorders and Health and Wellness

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Abnormal Behavior

• Behavior that is
• deviant (atypical)
• maladaptive (dysfunctional)
• personally distressing (despair)

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Theoretical Approaches

• Biological Approach Medical Model
• disorders with biological origins
• Psychological Approach
• experiences, thoughts, emotions, personality
• Sociocultural Approach
• social context
• Biopsychosocial Model
• interaction of biological, psychological and
  sociocultural factors

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DSM-IV Classification System

• Advantages
• provides a common basis for communication
• helps clinicians make predictions
• naming the disorder can provide comfort
• Disadvantages
• stigma (shame, negative reputation)
• medical terminology implies internal cause
• focus on weaknesses ignores strengths

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Psychological Disorders Real or Myth?

• Szasz Cruise
• phrase mental illness is presumptuous
• medication of mental illnesses is presumptuous
• Response of Medical Professionals
• mental illnesses are real medical conditions
• drugs effectively alleviate symptoms
• ADHD over-diagnosed or non-medical?
• should prescription drugs be used to treat ADHD?

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DSM-IV-TR Axes

• Multiaxial System
• Axis I and II Psychological Disorders
• Axis III General Medical Conditions
• Axis IV Psychosocial/Environmental Problems
• Axis V Current Level of Functioning

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Anxiety Disorders

• uncontrollable fears that are
• disproportionate and disruptive
• generalized anxiety disorder
• panic disorder
• phobic disorder
• obsessive-compulsive disorder
• post-traumatic stress disorder

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Generalized Anxiety Disorder

• Diagnosis and Symptoms
• persistent anxiety for at least 6 months
• inability to specify reasons for the anxiety
• Etiology
• biological factors
• - genetic predisposition, GABA deficiency,
  respiration
• psychological and sociocultural factors
• - harsh self-standards, critical parents,
  negative
• thoughts, trauma

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Panic Disorder

• Diagnosis and Symptoms
• recurrent, sudden onsets of intense terror that
  often occur without warning
• Etiology
• biological factors genetic predisposition
• psychological factors misinterpret arousal
• sociocultural factors gender differences

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Phobic Disorder

• Diagnosis and Symptoms
• an irrational, overwhelming, persistent fear of a
  particular object or situation (e.g., social
  phobia)
• Etiology
• biological factors genetic disposition
• psychological factors learned

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Examples of Phobic Disorders
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Social Phobias in the U.S.
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Obsessive-Compulsive Disorder

• Diagnosis and Symptoms
• persistent anxiety-provoking thoughts and/or
  urges to perform repetitive, ritualistic
  behaviors to prevent or produce a situation
• Etiology
• biological factors genetic predisposition
• psychological factors life stress

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Post-Traumatic Stress Disorder

• Diagnosis and Symptoms
• Symptoms develop as a result of exposure to a
• traumatic event, oppressive situation, natural or
• unnatural disasters
• - flashbacks
• - constricted ability to feel emotions
• - excessive arousal
• - difficulties with memory and concentration
• - feelings of apprehension
• - impulsive outbursts

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Post-Traumatic Stress Disorder

• Etiology
• trauma
• - combat and war-related
• - sexual abuse and assault
• - natural and unnatural disasters
• vulnerability
• - previous history of trauma
• - genetic predispositions

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Mood Disorders

• disturbance of mood that affects entire
  emotional state
• Symptoms may include
• cognitive, behavioral, or physical symptoms
• interpersonal difficulties
• Types
• major depressive disorder, dysthymic disorder
• bipolar disorder

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Major Depressive Disorder (MDD)

• Diagnosis and Symptoms
• significant depressive episode that lasts for at
  least two weeks
• defined by presence of at least 5 out of 9
  symptoms
• daily functioning is impaired

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Dysthymic Disorder (DD)

• Diagnosis and Symptoms
• chronic depression
• - unbroken depressed mood lasting at least two
  years (adult) or one year (child)
• fewer symptoms than MDD
• - defined by presence of 2 out of 6 symptoms

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Major Depressive Disorder (MDD)

• Etiology
• biological factors genetic disposition
• - underactive prefrontal cortex
• - regulation of neurotransmitters
• psychological factors
• - learned helplessness
• - ruminating on negative, self-defeating thoughts
• - pessimistic attribution
• sociocultural factors
• - poverty
• - gender differences

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Childhood Depression

• Developmental Psychopathology
• risk factors for depression
• - parental psychopathology
• - genetics
• protective factors
• - supportive adult role model, or strong
• extended family
• - genetics

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Bipolar Disorder

• Characterized by extreme mood swings
• Bipolar I and Bipolar II
• Frequency and separation of episodes
• usually separated by 6 months to a year
• Etiology
• strong genetic component
• swings in metabolic activity in cerebral cortex
• levels of neurotransmitters

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Suicide

• Prevalence
• over 32,000 in year 2004
• one completion for every 8 to 25 attempts
• 3rd leading cause of death in early adolescence

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Suicide

• Biological factors
• low levels of serotonin
• poor health
• Psychological Factors
• mental disorders
• trauma (recent/immediate and highly stressful)
• substance abuse
• Sociocultural Factors
• chronic economic hardship
• cultural and religious norms
• gender differences

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When Someone is Threatening Suicide
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Dissociative Disorders

• sudden loss of memory or change in identity
• Dissociation
• protection from extreme stress or shock
• problems integrating emotional memories
• Types
• dissociative amnesia
• dissociative fugue
• dissociative identity disorder (DID)

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Dissociative Disorders

• Dissociative Amnesia
• individuals experience extreme memory loss caused
  by extensive psychological stress
• Dissociative Fugue
• individuals experience amnesia, unexpectedly
  travel away, and sometimes assume a new identity

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Dissociative Identity Disorder

• Diagnosis and Symptoms
• the same individual possesses two or more
  distinct personalities
• each personality has unique memories, behaviors,
  and relationships
• only one personality is dominant at a time
• personality shifts occur under distress
• Etiology
• extraordinarily severe abuse in early childhood
• social contagion
• mostly women
• runs in families

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Schizophrenia

• highly disordered thought
• split from reality (psychotic)
• typically diagnosed in early adulthood
• high suicide risk

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Symptoms of Schizophrenia

• Positive Symptoms
• hallucinations and delusions
• thought disorders and disorders of movement
• Negative Symptoms
• flat affect
• Cognitive Symptoms
• attention difficulties and memory problems
• impaired ability to interpret information and
  make decisions

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Etiology of Schizophrenia

• Biological Factors
• genetic predisposition
• structural brain abnormalities
• regulation of neurotransmitters
• Psychological Factors
• diathesis-stress model
• Sociocultural Factors
• influence how disorder progresses

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Personality Disorders

• chronic maladaptive cognitive-behavioral
  patterns
• Antisocial Personality Disorder
• Diagnosis and Symptoms
• - guiltless lawbreaking, violence, deceit
• - impulsive, irritable, reckless, irresponsible
• Etiology
• - biological factors (genetic, brain, and ANS
  differences)

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Personality Disorders

• Borderline Personality Disorder
• Diagnosis and Symptoms
• instability in interpersonal relationships
  self-image
• impulsive, insecure, unstable extreme emotions
• Etiology
• genetic
• childhood abuse
• irrational belief one is powerless, unacceptable,
  and that others are hostile

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Psychological Disorders andHealth and Wellness

• Stereotypes and Stigma
• Rosenhans study - fake psychiatric patients
• negative attitudes toward mentally ill
• physical health risk
• successfully functioning individuals with mental
  illness reluctant to come out

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Chapter Summary

• Discuss the characteristics, explanations, and
  classifications of abnormal behavior.
• Distinguish among the various anxiety disorders.
• Compare the mood disorders and specify risk
  factors for depression and suicide.
• Describe the dissociative disorders.
• Characterize schizophrenia.
• Identify behavior patterns typical of personality
  disorders.
• Explain the impact of the stigma associated with
  mental illness.

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Chapter Summary

• Abnormal Behavior
• deviant, maladaptive, or personally distressing
• Theoretical Approaches
• biological, psychological, and sociocultural
• biopsychosocial
• Classifying Abnormal Behavior
• DSM-IV-TR Axes
• advantages and disadvantages

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Chapter Summary

• Anxiety Disorders
• generalized anxiety disorder
• panic disorder
• phobic disorder
• obsessive-compulsive disorder
• post-traumatic stress disorder

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Chapter Summary

• Mood Disorders
• major depressive disorder
• dysthymic disorder
• bipolar disorder
• suicide
• Dissociative Disorders
• dissociative amnesia
• dissociative fugue
• dissociative identity disorder

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Chapter Summary

• Schizophrenia
• positive, negative and cognitive symptoms
• etiology (biological, psychological,
  sociocultural)
• Personality Disorders
• antisocial personality disorder
• borderline personality disorder
• Psychological Disorders and Health Wellness
• stigmas and stereotypes