Chapter 13: Psychological Disorders
Psychological Disorder
a “harmful dysfunction” in which behavior is judged to be:
atypical--not enough in itself
disturbing--varies with time and culture
maladaptive--harmful
unjustifiable--sometimes there’s a good reason
Medical Model
concept that diseases have physical causes---can be diagnosed, treated, and in most cases,
cured
assumes that these “mental” illnesses can be diagnosed on the basis of their symptoms and
cured through therapy, which may include treatment in a psychiatric hospital
Bio-Psycho-Social Perspective
assumes that biological, sociocultural, and psychological factors combine and interact to
produce psychological disorders
Classifying Psychological Disorders
DSM-IV
American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders
(Fourth Edition)
a widely used system for classifying psychological disorders Updated in 2000 and referred to as
the “text revision,”
Anxiety Disorders
distressing, persistent anxiety or maladaptive behaviors that reduce anxiety
Anxiety - diffuse, vague feelings of fear and apprehension
everyone experiences it
becomes a problem when it is irrational, uncontrollable, and disruptive
Generalized Anxiety Disorder
person is tense, apprehensive, and in a state of autonomic nervous system arousal
More or less constant worry about many issues
Physical symptoms: headaches; stomachaches; muscle tension; irritability
Panic Disorder
an anxiety disorder in which the anxiety may at times suddenly escalate into a terrifying
panic attack, a minutes-long episode of intense dread in which a person experiences terror and
accompanying chest pain, choking, or other frightening sensations.
Panic attacks - helpless terror, high physiological arousal
Very frightening - sufferers live in fear of having them
Agoraphobia often develops as a result
Phobia
persistent, irrational fear of a specific object or situation
Intense, irrational fear that may focus on:
category of objects
event or situation
social setting
It is not phobic to simply be anxious about something
Specific phobias - fear of specific object
Obsessive-Compulsive Disorder
an anxiety disorder characterized by unwanted repetitive thoughts (obsessions) and/or actions
(compulsions).
Obsessions - irrational, disturbing thoughts that intrude into consciousness
Compulsions - repetitive actions performed to alleviate obsessions
The learning perspective views anxiety disorders as a product of fear conditioning, stimulus
generalization, reinforcement, and observational learning.
Explaining Anxiety Disorders:
The biological perspective emphasizes evolutionary, genetic, and physiological influences.
Dissociative Disorders
conscious awareness becomes separated (dissociated) from previous memories, thoughts, and
feelings
Dissociative Identity Disorder
rare dissociative disorder in which a person exhibits two or more distinct and alternating
personalities
formerly called multiple personality disorder
Personality Disorders
disorders characterized by inflexible and enduring behavior patterns that impair social
functioning
Antisocial Personality Disorder
disorder in which the person (usually man) exhibits a lack of conscience for wrongdoing,
even toward friends and family members
may be aggressive and ruthless or a clever con artist
Mood Disorders
characterized by emotional extremes
Major Depressive Disorder
a mood disorder in which a person, for no apparent reason, experiences two or more weeks of
depressed moods, deep unhappiness, lethargy, feelings of worthlessness, and diminished
interest or pleasure in most activities.
prolonged, very severe depression; lasts without remission for at least 2 weeks
Symptoms of Depression
Dysthymia
less severe, but long-lasting depression
lasts for at least 2 years
Can have both at the same time
Women diagnosed far more often than men
Manic Episode
a mood disorder marked by a hyperactive, wildly optimistic state
Bipolar Disorder-- formerly called manic-depressive disorder: cycling between depression and
mania (extreme euphoria)
a mood disorder in which the person alternates between the hopelessness and lethargy of
depression and the overexcited state of mania, (euphoric, hyperactive, wildly optimistic states).
Seasonal Affective Disorder: Cyclic severe depression and elevated mood
Seasonal regularity
Unique cluster of symptoms
intense hunger
gain weight in winter
sleep more than usual
depressed more in evening than morning
Explaining Mood Disorder:
The biological perspective emphasizes the importance of genetic and biochemical influences.
Mood disorders run in families--search for genes that put people at risk Certain
neurotransmitters, including norepinephrine and serotonin, seem to be scarce in depression. The
brains of depressed people have been found to be less active.
The social-cognitive perspective sees depression as a vicious cycle in which (1) negative,
stressful events are interpreted through (2) a ruminating, pessimistic explanatory style, creating
(3) a hopeless, depressed state that (4) interferes with the way a person thinks and acts. This
causes: (1) more negative experiences.
Cognitive Bases for Depression
A.T. Beck: depressed people hold pessimistic views of
Themselves; the world; the future
Depressed people distort their experiences in negative ways
exaggerate bad experiences; minimize good experiences
Situational Bases for Depression
Positive correlation between stressful life events and onset of depression
Is life stress causal of depression?
Most depressing life events are losses: spouse or companion; long-term job; health; income
Schizophrenia
literal translation “split mind”--- ‘split’ refers to loss of touch with reality
not dissociative state, not ‘split personality’
a group of severe disorders characterized by:
disorganized and delusional thinking
disturbed perceptions
inappropriate emotions and actions
Equally split between genders, males have earlier onset
18 to 25 for men
26 to 45 for women
Symptoms of Schizophrenia
Delusions
false beliefs, often of persecution or grandeur, that may accompany psychotic disorders
Hallucinations
sensory experiences without sensory stimulation
Positive symptoms: hallucinations; delusions
Negative symptoms: absence of normal cognition or affect (e.g., flat affect, poverty of speech)
Disorganized symptoms
disorganized speech (e.g., word salad)
disorganized behaviors
Delusions of persecution
‘they’re out to get me’; paranoia;
Delusions of grandeur
Delusions of being controlled
the CIA is controlling my brain with a radio signal
Disorganized speech
overinclusion - jumping from idea to idea without the benefit of logical association
Disorganized behavior and affect
Subtypes of Schizophrenia
Paranoid type
delusions of persecution
believes others are spying and plotting
delusions of grandeur
believes others are jealous, inferior, subservient
Catatonic type - unresponsive to surroundings, purposeless movement, parrot-like speech
Disorganized type
delusions and hallucinations with little meaning
disorganized speech, behavior, and flat affect
Schizophrenia and Genetics
risk increases with genetic similarity
Biological Bases of Schizophrenia
Other congenital influences
difficult birth (e.g., oxygen deprivation)
prenatal viral infection
Brain chemistry
neurotransmitter excesses or deficits
The Dopamine Theory: Drugs that reduce dopamine reduce symptoms
Other Biological Factors
Brain structure and function
Family Influences on Schizophrenia
Family variables
parental communication that is disorganized, hard-to-follow, or highly emotional
expressed emotion
Cultural Differences in Schizophrenia
Prevalence of symptoms is similar no matter what the culture
Less industrialized countries have better rates of recovery than industrialized countries
families tend to be less critical of the schizophrenic patients
less use of antipsychotic medications, which may impair full recovery
think of Schizophrenia as transient, rather than chronic and lasting disorder
Rates of Psychological Disorders