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Chapter 14 Lecture Notes – Psychological Disorders
Modules 47, 48, 49, 50, & 51
Early Explanations of Mental Illness
 In ancient times holes were cut in an ill person’s head to let out evil spirits in a process called
__________________.
 Hippocrates believed that mental illness came from an imbalance in the body’s four humors.
 During the Middle Ages, people believed in spirit possession (through the teachings of the
church) resulting in the “treatment” of exorcism – _____________________________________
_______________________________________________
 During the Renaissance, the mentally ill were labeled as witches and often put to death
Definitions of Abnormality
 Psychopathology - the study of abnormal behavior.
 Psychological disorders - _________________________________________________________
______________________________________________________________________________
 Definitions of Abnormality:

Statistically rare

Deviant from social norms
○
Situational context - the social or environmental setting of a person’s behavior.

Subjective discomfort - emotional distress or emotional pain.

Maladaptive - ____________________________________________________________
________________________________________________________________________
Biology and Psychopathology
 Biological model – model of explaining behavior as caused by biological changes in the
chemical, structural, or genetic systems of the body.
Psychological Viewpoints of Psychopathology
 Psychoanalytic theorists - assume that abnormal behavior stems from repressed conflicts and
urges that are fighting to become conscious.
 Behaviorists - see abnormal behavior as learned.
 Cognitive theorists - _____________________________________________________________
______________________________________________________________________________
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Culture and Psychopathology
 _________________________ - the need to consider the unique characteristics of the culture in
which behavior takes place.
 Culture-bound syndromes – disorders found only in particular cultures.

Koro – a fear that one’s genitals are shrinking (found primarily in China and a few other
South Asian and East Asian countries)

Amok – results from a perceived insult or slight, which is followed by a period of
brooding and then a violent or aggressive outburst, during which the person may attack
others and may not remember doing so (term comes from Southeast Asia, but similar
concepts also found in Latin America and certain Native American tribes)

Anorexia Nervosa – eating disorder that minimizes food intake (found almost exclusively
in Western cultures such as the United States and Great Britain)
DSM-IV-TR
 _____________________________________________________________________________ is
a manual of psychological disorders and their symptoms.
Types of Disorders
 There are five axes in the DSM-IV-TR, which include ____________________________________
______________________________________________________________________________
______________________________________________________________________________
 Over one-fifth of all adults over age 18 suffer from a mental disorder in any given year.
 Major depression is one of the most common psychological disorders worldwide.
Five Axes Example
 Axis 1 296.23 Major Depressive Disorder, Single Episode, Severe Without Psychotic Features
305.00 Alcohol Abuse
 Axis 2 301.6 Dependent Personality Disorder
 Axis 3 410.90 Infarction, myocardial, acute
 Axis 4 Threat of job loss
 Axis 5 GAF = 45 (on admission)
GAF = 65 (at discharge)
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Somatoform Disorders
 Somatoform disorders - __________________________________________________________
______________________________________________________________________________
Different from

Psychosomatic disorder - disorder in which psychological stress causes a real physical
disorder or illness.

Psychophysiological disorder - modern term for psychosomatic disorder.
 Hypochondriasis -_______________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
 ________________________ - somatoform disorder in which the person dramatically complains
of a specific symptom such as nausea, difficulty swallowing, or pain for which there is no real
physical cause.
 Conversion disorder – ____________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Causes of Somatoform Disorders
 Psychoanalytic explanations of somatoform disorders assume that anxiety is turned into a
physical symptom.
 Behavioral explanations point to the negative reinforcement experienced when the “ill” person
escapes unpleasant situations such as combat; or positive reinforcement in the form of
attention from doctors, family members, and others.
 Cognitive explanations assume that people magnify their physical symptoms and normal bodily
changes into ailments out of irrational fear.
Dissociative Disorders
 Dissociative disorders – __________________________________________________________
______________________________________________________________________________
 Dissociative amnesia - loss of memory for personal information or specific personal events;
either partial or complete.

Often associated with a stressful or traumatic experience
 Dissociative fugue - ______________________________________________________________
______________________________________________________________________________
 _________________________________ – dissociative disorder in which a person feels detached
and disconnected from themselves, their bodies, and their surroundings.
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 _________________________________ - ____________________________________________
______________________________________________________________________________

Much controversy about the existence of this disorder – many believe it does not exist (faked)
○
Only experienced in North America – minimal to no cases across the world
Sybil Controversy
 There is taped evidence to suggest that the psychiatrist treating “Sybil,” the famous multiple
personality case, may have suggested to “Sybil” that she view her emotions as separate personalities.

Book released 1973; movie 1976
○
Before the publication of ‘Sybil’ only 76 current cases; after the book: 1,000
cases by 1984; 4,000 by 1989; 20,000-30,000 by the 1990s

Many professionals believe that these individuals are “playing out” the expected role by
responding to therapist suggestion – often done by hypnosis (remember flaws to this
technique)

The question may not necessarily be “does DID exist?” but rather “what causes a person
to exhibit symptoms of DID?”
Development of Dissociative Disorders
 Psychoanalytic explanations point to repression of memories, seeing dissociation as a defense
mechanism against anxiety.
 Cognitive and behavioral explanations see dissociative disorders as a kind of avoidance learning.
 Biological explanations point to lower than normal activity levels in the areas responsible for
body awareness in people with dissociative disorders.
Personality Disorders
 Personality disorders - ___________________________________________________________
______________________________________________________________________________

Antisocial personality disorder - _____________________________________________
________________________________________________________________________
________________________________________________________________________

___________________________ - maladaptive personality pattern in which the person
is moody, unstable, lacks a clear sense of identity, and often clings to others.
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Causes of Personality Disorders
 Psychoanalysts blame an inadequate resolution to the Oedipal complex for personality
disorders, stating that this results in a poorly developed superego.
 Cognitive-learning theorists see personality disorders as a set of learned behavior that has
become maladaptive—bad habits learned early on in life. Belief systems of the personality
disordered person are seen as illogical.
 Biological explanations look at the lower than normal stress hormones in antisocial personality
disordered persons as responsible for their low responsiveness to threatening stimuli.
 Other possible causes of personality disorders may include______________________________
______________________________________________________________________________
______________________________________________________________________________
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Anxiety Disorders
 Anxiety disorders - disorders in which the main symptom is excessive or unrealistic anxiety and
fearfulness.

Free-floating anxiety - anxiety that is unrelated to any realistic, known source.
 Phobia - _______________________________________________________________________

Social phobia - ___________________________________________________________
________________________________________________________________________

Specific phobia - fear of objects or specific situations or events.
○
Five “types”

Animal – e.g., animals or insects

Natural – e.g., storms, heights, water
-




Acrophobia - fear of heights.
Blood-injection – seeing blood or receiving an injection
-
Hematophobia – fear of blood
-
Trypanophobia – fear of injections
Situational – e.g., bridges, elevators, flying, driving, enclosed places
-
Claustrophobia - fear of being in a small, enclosed space.
-
Odontophobia – fear of dental work
Other – e.g., fear of choking, vomiting, contracting an illness
__________________ - ____________________________________________________
________________________________________________________________________
 Obsessive-compulsive disorder – ___________________________________________________
______________________________________________________________________________
______________________________________________________________________________
 Panic disorder – disorder in which panic attacks occur frequently enough to cause the person
difficulty in adjusting to daily life.

Panic attack - ____________________________________________________________
________________________________________________________________________
 Panic disorder with agoraphobia - __________________________________________________
______________________________________________________________________________
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 Generalized anxiety disorder - disorder in which a person has feelings of dread and impending
doom along with physical symptoms of stress, which lasts six months or more.
 Posttraumatic stress disorder (PTSD)- _______________________________________________
______________________________________________________________________________
______________________________________________________________________________

A few examples of symptoms include anxiety, recurring nightmares, sleep disturbances,
problems in concentration, and moments in which the event is “relived” through
dreams and flashbacks
 Acute stress disorder – similar to PTSD, but symptoms last no more than a month
Causes of Anxiety Disorders
 Psychoanalytic explanations point to repressed urges and desires that are trying to come into
conscious, creating anxiety that is controlled by the abnormal behavior.
 Behaviorists ____________________________________________________________________
______________________________________________________________________________
 Cognitive psychologists believe that excessive anxiety comes from illogical, irrational thought
processes.

Magnification - the tendency to interpret situations as far more dangerous, harmful, or
important than they actually are.

________________________ - the tendency to believe that one’s performance must be
perfect or the result will be a total failure.

Overgeneralization - ______________________________________________________
________________________________________________________________________

Minimization - the tendency to give little or no importance to one’s successes or
positive events and traits.
 Biological explanations of anxiety disorders include chemical imbalances in the nervous system,
in particular serotonin and GABA (inhibitory) systems.
Mood Disorders
 Affect – in psychology, an emotional reaction.
 Mood disorders - disorders in which mood is severely disturbed.

Can range from extreme sadness to extreme elation

Can be brief acute episodes to long lasting chronic dispositions
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 _______________________________ - severe depression that comes on suddenly and seems to
have no external cause; or if there is an external cause, the depression is excessive; at least one
major depressive episode experienced

Major depressive episode – ________________________________________________
________________________________________________________________________
 Bipolar disorder - ______________________________________________________________________

Bipolar I – Manic episode (or mixed) and/or depressive episode

Bipolar II – Hypomanic episode AND major depressive episode

Manic - ________________________________________________________________________
 ____________________- a moderate depression that lasts for two years or more and is typically
a reaction to some external stressor.
 ____________________ - disorder that consists of mood swings from moderate depression to
hypomania (“low mania”) and lasts two years or more.
Causes of Mood Disorders
 Psychoanalytic theories see depression as anger at authority figures from childhood turned
inward on the self.
 Learning theories link depression to learned helplessness.
 Cognitive theories see depression as the result of distorted, illogical thinking. *ALSO see causes
of Anxiety Disorders*
 Biological explanations of mood disorders look at the function of serotonin, norepinephrine,
and dopamine systems in the brain.
Seasonal Affective Disorder
 Seasonal affective disorder (SAD) - _________________________________________________
______________________________________________________________________________

Phototherapy - the use of lights to treat seasonal affective disorder or other disorders.
Schizophrenia
 Schizophrenia - _________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Psychotic - the break away from an ability to perceive what is real and what is fantasy.
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 _______________________ - symptoms of schizophrenia that are excesses of behavior or occur
in addition to normal behavior; hallucinations, delusions, and distorted thinking.

Hallucinations - __________________________________________________________
________________________________________________________________________

_______________ - _______________________________________________________
________________________________________________________________________

○
Persecution – others are trying to hurt them in some way
○
Reference – other people, television characters, or books are specifically talking
to them
○
Influence – being controlled by external forces, such as the devil, aliens, or
cosmic forces
○
Grandeur – convinced that they are powerful people who can save the world or
have a special mission
Delusional disorder - a psychotic disorder in which the primary symptom is one or more
delusions (other symptoms must be present for schizophrenia).
 __________________________ - symptoms of schizophrenia that are less than normal behavior
or an absence of normal behavior; poor attention, flat affect, and poor speech production.

Flat affect - ______________________________________________________________

At least two or more of the following symptoms must be present frequently for at least
one month to diagnose schizophrenia: delusions, hallucinations, disturbed speech,
disturbed emotions, and disturbed behavior
Types of Schizophrenia
 Disorganized - type of schizophrenia in which _________________________________________
______________________________________________________________________________
 _______________ - type of schizophrenia in which the person experiences periods of statue-like
immobility mixed with occasional bursts of energetic, frantic movement and talking.
 Paranoid - _____________________________________________________________________
______________________________________________________________________________
 __________________________ - type of schizophrenia in which the person shows no particular
pattern, shifting from one pattern to another, and cannot be neatly classified as disorganized,
paranoid, or catatonic.
 Residual - type of schizophrenia in which there are no delusions and hallucinations, but the
person still experiences negative thoughts, poor language skills, and odd behavior.
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Causes of Schizophrenia
 Psychoanalytic theories see schizophrenia as resulting from a severe breakdown of the ego,
which has become overwhelmed by the demands of the id and results in childish, infantile
behavior.
 Behaviorists focus on how reinforcement, observational learning, and shaping affect the
development of the behavioral symptoms of schizophrenia.
 Cognitive theorists see schizophrenia as severely irrational thinking.
 Biological explanations focus on dopamine, structural defects in the brain, and genetic
influences in schizophrenia.
 Stress-vulnerability model - _______________________________________________________
______________________________________________________________________________
______________________________________________________________________________
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