Psychological Disorders
Prevalence of Psychological Disorders
 In a year in the U.S.:
 20% of persons experience psychological
problems severe enough to adversely affect their
daily living.
 40% of persons experience at least mild mental
health problems.
 About 2.1 million people are admitted to hospitals
due to serious psychological problems.
 Worldwide:
 About 400 million people are afflicted with
psychological disorders.
How Should We Understand
Psychological Disorders?
 The medical model proposes that
psychological disorders have a biological basis
and can be classified into discrete categories
and are analogous to physical diseases.
How Should We Understand Psychological
Disorders?
 Although not agreeing that all mental health
problems have a biological basis, mainstream
psychology has adopted the medical model’s
terminology.
 Symptom: a sign of a disorder
 Diagnosis: distinguishing one disorder from another
 Etiology: a disorder’s apparent causes and
developmental history
 Prognosis: prediction about the likely course of a
disorder
Defining Psychological Disorders
 A pattern of atypical behavior
 Results in personal distress or
 Significant impairment in a person’s social or
occupational functioning
Numerous Theoretical Explanations
 Five primary perspectives to understand mental
illness:
 Psychodynamic: Disordered behavior is controlled by
unconscious forces shaped by childhood experiences.
 Behavioral: Disordered behavior is caused by identifiable
factors in the person’s environment and results from learning.
 Cognitive: ineffective or inaccurate thinking is the root
cause of mental illness
Numerous Theoretical Explanations
 Five primary perspectives to understand mental
illness:
 Sociocultural: Mental illness is the product of broad social
and cultural forces .
 Biological: Disordered behavior is caused by biological
conditions, such as genetics, hormone levels, or
neurotransmitter activity in the brain.
Combined Models
 Diathesis-stress model: a predisposition to a given
disorder (diathesis) that combines with
environmental stressors to trigger a psychological
disorder
 Bio-psycho-social model. Takes into account
predispositions, personal experience, and life
circumstances.
The Diathesis-Stress Model
Psychological Disorders
Biological
(Evolution,
individual
genes, brain
structures
and chemistry)
Sociocultural
(Roles, expectations,
definition of normality
and disorder)
Psychological
(Stress, trauma,
learned helplessness,
mood-related perceptions
and memories)
 Bio-psycho-social
Perspective
 assumes that
biological,
sociocultural, and
psychological factors
combine and interact
to produce
psychological
disorders
Models from Outside Psychology
 Spirit Possession
 Trephining
 Lunacy
 Curses
 Family/generational
 Occult (voodoo, witchcraft)
 Sin
 Guilt
 Unforgiveness, bitterness
Risks of Using Diagnostic Labels
 David Rosenhan demonstrated diagnostic labels’
biasing effects.

Misdiagnosis of insanity by hospital personnel due to their
bias toward calling a healthy person sick
 Diagnostic labels can harm patients in several
ways.

Label may “dehumanize” patients by encouraging mental
health practitioners to treat them as labels rather than as
unique individuals with problems.

Labeled individuals may experience discrimination and may
cause people to expect those labeled to behave abnormally
and thus to misperceive normal behavior as disordered.
Benefits of Using Diagnostic Labels
 Despite ethical concerns, diagnostic labels are
used because they serve several important
functions:

Summarize patient’s symptoms or problems, and thus,
communicate great deal of information with a single word

Convey information about possible causes of the disorder

Convey information about the patient’s prognosis
DSM Classification System
 Diagnostic and Statistical Manual of Mental
Disorders (DSM) use to diagnose mental disorders
 Published by the American Psychiatric Association.
 Since 1980, DSM has been updated several times and
is now in its fourth edition, text revision, or DSM-IV-TR.
DSM Classification System
 DSM classification system is descriptive rather than
explanatory, meaning that:
 it is not based on a particular theory concerning the
cause(s) of psychological disorders.
 diagnoses are based mainly on observable symptoms.
 DSM provides clearer directions concerning
number, duration, and severity of symptoms
necessary to assign a diagnosis.
 By recognizing that two patients with same disorder may
substantially differ from one another, clinicians much more
likely to acknowledge uniqueness of all patients.
Anxiety Disorders: Distressing, Persistent
Anxiety, Maladaptive Behavior
 Characterized by distressing, persistent anxiety or
maladaptive behavior
 About 25 percent of the population will experience
this disorder in our lifetime.
 Anxiety disorders occur across the life span and
commonly co-occur with many other disorders, such
as depression and substance abuse.
Anxiety Disorders: Distressing, Persistent
Anxiety, Maladaptive Behavior
 Five major anxiety disorders:
 Panic disorder: brief episodes of intense anxiety with no
apparent reason
 Phobic disorder: strong irrational fears of specific objects
or situations, called phobias
 Generalized anxiety disorder (GAD): a constant state of
moderate anxiety
Anxiety Disorders: Distressing,
Persistent Anxiety, Maladaptive Behavior
 Five major anxiety disorders:
 Obsessive-compulsive disorder: repetitive, unwanted, and
distressing actions and/or thoughts
 Post-traumatic stress disorder: occurs among individuals
who have experienced or witnessed traumatic events
 Later reexperience the event through nightmares, flashbacks, and
avoid situations or persons that trigger flashbacks
Anxiety Disorders
Common Obsessions and Compulsions Among
People With Obsessive-Compulsive Disorder
Thought or Behavior
Percentage*
Reporting Symptom
Obsessions (repetitive thoughts)
Concern with dirt, germs, or toxins
40
Something terrible happening (fire, death, illness)
24
Symmetry order, or exactness
17
Compulsions (repetitive behaviors)
Excessive hand washing, bathing, tooth brushing,
or grooming
85
Repeating rituals (in/out of a door,
up/down from a chair)
Checking doors, locks, appliances,
car brake, homework
51
46
Anxiety Disorders
 PET Scan of brain of
person with obsessive/
compulsive disorder
 High metabolic activity
(red) in frontal lobe
areas involved with
directing attention
Etiology of Anxiety Disorders
 Genetic and biological factors:

Genetic heritage may predispose us to more easily develop
phobic reactions or to respond intensely to stressful events.
 Behavioral or conditioning factors:

Classical conditioning may instill conditioned emotional
responses, and operant conditioning may reinforce and
maintain the person’s avoidance responses.
 Cognitive factors:

People suffering from panic disorder closely monitor their
physiological reactions, and often exaggerate the significance
of their physiological symptoms.
Mood Disorders: Emotional Extremes
 Characterized by emotional extremes that cause
significant disruption in daily functioning.

To qualify as a mood disorder, emotional extremes must
persist for a long time.
 Most common mood disorder is depression

Characterized by extreme and persistent negative moods
and the inability to experience pleasure by participating in
activities one previously enjoyed (Kramlinger, 2001)
Mood Disorders: Emotional Extremes
 Depressed individuals:

Often experience physiological problems such as lack of
appetite, weight loss, fatigue, and sleep disorders

Often experience behavioral symptoms, such as slowed
thinking and acting, social withdrawal, and decreased activity

Exhibit cognitive symptoms, such as low self-esteem, thinking
about death and/or suicide, and having little hope for the future
Mood Disorders-Depression
 The vicious
1
Stressful
experiences
4
Cognitive and
2
Negative
behavioral changes
explanatory style
3
Depressed
mood
cycle of
depression
can be broken
at any point
Hostile & Pessimistic Persons Are More Reactive to
Stressors
 Pessimistic explanatory style:
 tendency to explain cause of negative uncontrollable events
as one’s own stable personal qualities affecting all aspects
of life
 Associated with health problems and premature death
 Optimistic explanatory style:
 tendency to explain cause of uncontrollable negative events
as temporary, external factors that do not affect other
aspects of one’s life
 Associated with good health and longevity
Mood Disorders-Depression
25
Percentage
of population
aged 18-84
experiencing
major
depression
at some
point In life
Around the world
women are more
susceptible to
depression
20
20
15
15
10
10
5
5
0
0
USA Edmonton Puerto
Rico
Males
Females
Paris
West
Florence Beirut
Germany
Taiwan
Korea
New
Zealand
Mood Disorders: Emotional Extremes
 Bipolar disorder: characterized by swings between the
emotional extremes of mania and depression
 Less common than major depressive disorder, occurring in
about 1 percent of the population
 Unlike major depression, this disorder occurs about
equally in men and women and tends to occur earlier than
major depression
Mood Disorders: Emotional Extremes
 Bipolar disorder
 Bipolar patients’ depressive episodes differ from the
depressive episodes in major depression in that they
tend to be more severe, are accompanied by higher
suicide risks, and have a distinct pattern of brain activity
during sleep.
Mood Disorders-Bipolar
 PET scans show that brain energy consumption
rises and falls with emotional swings
Depressed state
Manic state
Depressed state
Suicide
 A major danger of depression is suicide.
 As many as 30% of people with severe mood disorders
die from suicide.
 In the U.S. suicide rates are higher among:
 Men than women;
 Elderly adults than younger adults;
 Unemployed (& retired) adults than employed persons;
 Widowed adults than married adults;
 Native & European Americans than Asian. Hispanic, and
African Americans.
Etiology of mood disorders
 Genetic/ biological influence?
 Bipolar patients show imbalances in neural circuits using
serotonin, norepinephrine, etc.? Enlarged amygdala?
 Major depressive disorder: Family, twin, and adoption studies
indicate at least a moderate genetic influence on depression.
 Cognitive contributions:
 Depressed persons have negative views and they
misinterpret daily experiences so that their negative
outlook is supported.
 Behavioral psychologists propose that depression
results from low social reinforcement.
Gender & Mood Disorders
 Why is depression more common among women?
 May due to biological factors.
 Sociocultural factors: Women have fewer educational and
occupational opportunities, receive less money for their work, and
experience more violence due to their gender than men.
 Difference in diagnosis?
 Women may be diagnosed more frequently because they are
more likely to seek help for their problems.
 Gender bias among mental health professionals may result in
women and men with identical symptoms being diagnosed
differently, i.e., women labeled as depressed and men diagnosed
with other conditions
Dissociative Disorders: Loss of Contact
with Consciousness or Memory
 Characterized by disruptions in
consciousness, memory, sense of identity, or
perception
 Dissociative amnesia: a sudden loss of memory
of one’s identity and other personal information
 Dissociative fugue: a sudden departure from
home or work, combined with loss of memory of
identity and the assumption of a new identity
Dissociative Disorders: Loss of Contact with
Consciousness or Memory
 Dissociative identity disorder (DID): characterized
by the presence of two or more distinct identities
or personalities, which take turns controlling the
person’s behavior (also known as multiple
personality disorder)
Etiology of Dissociative Disorders
 Psychodynamic theory: results from the individual’s
attempt to repress some troubling event
 Biological explanation: patient may have a neurological
problem that has not yet been detected
 Cognitive perspective: individuals learn to dissociate as
a way to cope with intense distress
Schizophrenia: Disturbances in Almost All
Areas of Psychological Functioning
 Characterized by severe impairment in thinking,
including hallucinations, delusions, or loose
associations
 Diagnosed when symptoms persist for at least six
months, are not due to some other condition, and
cause significant impairment in daily functioning
 Schizophrenics often cannot work, manage a home
or apartment successfully, or care for their basic
needs.
Schizophrenia
 Delusions
 false beliefs, often of persecution or
grandeur, that may accompany psychotic
disorders
 Hallucinations
 false sensory experiences such as seeing something
without any external visual stimulus
Risk of Developing Schizophrenia
Personality Disorders: Inflexible Behavior
Patterns That Impair Social Functioning
 Personality disorders: general styles of living that
are ineffective and lead to problems for the person
and for others
 Ten personality disorders in the DSM-IV-TR.
Personality Disorders: Inflexible Behavior
Patterns That Impair Social Functioning
 Three common personality disorders are:
 Paranoid personalities: habitually distrustful and
suspicious of others’ motives
 Histrionic personalities: excessively emotional and
attention seeking, often turning minor incidents into fullblown dramas
 Narcissistic personalities: desire constant admiration
from others
Personality Disorders: Inflexible Behavior
Patterns That Impair Social Functioning
 The personality disorder that receives the most
attention is the antisocial personality disorder.

Exhibit a persistent pattern of disregard for and violation of the
rights of others

Repeatedly exhibit antisocial behavior across all realms of life, lying,
cheating, stealing, and manipulating others

When caught, they take no responsibility and feel no remorse.
Personality Disorders
Adrenaline 15
excretion(ng/min)
Those with criminal
convictions have lower
levels of arousal
10
5
0
Nonstressful
situation
Stressful
situation
No criminal conviction
Criminal conviction
Personality Disorders
PET scans illustrate reduced activation in a
murderer’s frontal cortex
Normal
Murderer
Etiology of Personality Disorders
 A genetic component: related to abnormal brain
development or chronic underarousal of both the
autonomic and central nervous systems
 May be caused by the interaction of both biological and
environmental factors.
 Children in chaotic households who have a biological
predisposition for this disorder may not learn to control
their impulses, and so behave in ways to maximize
their benefit even if this means violating social rules.