LECTURE OUTLINE
I.
What Are Psychological Disorders?
A.
Psychological disorders are behaviors or mental processes connected with various kinds of distress or disability.
B.
Disorders are characterized on the following criteria:
1.
They are unusual.
2.
They suggest faulty perception or interpretation of reality.
a.
Hearing voices, seeing things, hallucinations, ideas of persecution.
3.
The person’s emotional response is inappropriate to the situation.
4.
They are self-defeating.
5.
They are dangerous.
6.
The individual’s behavior is socially unacceptable.
C.
Perspectives on psychological disorders have morphed over the years.
1.
The demonological model holds that psychological disorders are caused by possession by the devil.
2.
The medical model assumes that illnesses have physical or biological causes that can be identified and that people afflicted can be cured through treatment or therapy.
3.
The diathesis-stress model assumes that there may be biological differences between individuals (diatheses) that explain why some people develop certain psychological disorders under stress, whereas others do not.
4.
The biopsychosocial model explains psychological disorders in terms of a combination of biological vulnerability, psychological factors, and sociocultural factors.
D.
Classifying psychological disorders
1.
The most widely used classification scheme for psychological disorders is the
Diagnostic and Statistical Manual (DSM) of the American Psychiatric
Association. a.
The current edition of the DSM is the DSM-IV-TR (4 th
edition, text revised).
2.
Some have expressed concerns with the DSM-IV-TR.
a.
Reliability: different interviewers make the same diagnosis when they evaluate the same people.
b.
Validity: diagnosis in the manual corresponds to clusters of behaviors seen in the real world. i.
Predictive validity: if the diagnosis is valid, then we should be able to predict what will happen to the person over time.
E.
Prevalence of psychological disorders

Chapter 12: Psychological Disorders
1.
About half of us will meet the criteria for a DSM-IV disorder at some time or another in our lives
2.
Slightly more than one-quarter will experience a disorder in a given year.
II.
Anxiety Disorders
A.
Psychological and Physical Features.
1.
Psychological features: a.
Worrying. b.
Fear of the worst things happening. c.
Fear of losing control. d.
Nervousness. e.
Inability to relax.
2.
Physical features: a.
Arousal of the sympathetic branch of the autonomic nervous system, for example, i.
Trembling. ii.
Sweating. iii.
Pounding heart. iv.
Elevated blood pressure. v.
Faintness.
3.
Anxiety is an appropriate response to a real threat.
B.
Types of Anxiety Disorders
1.
Specific phobias are excessive, irrational fears of specific objects or situations, such as snakes or heights. a.
Social phobias are persistent fears of scrutiny by others or of doing something that will be humiliating or embarrassing. b.
Examples of phobias include i.
Acrophobia: fear of heights (specific). ii.
Claustrophobia: fear of tight or enclosed places (specific). iii.
Fear of public speaking (social). iv.
Agoraphobia: fear of being out in open, busy areas.
2.
Panic disorder is an abrupt attack of acute anxiety not triggered by a specific object or situation. a.
Symptoms: i.
Shortness of breath. ii.
Heavy sweating. iii.
Tremors. iv.
Pounding of heart. v.
Many fear suffocation. vi.
Choking sensations. vii.
Nausea. viii.
Numbness. ix.
Fear of going crazy or losing control. b.
Symptoms may last minutes or hours and seem to come from nowhere.
3.
Generalized anxiety disorder is persistent anxiety that cannot be attributed to a phobic object, situation, or activity. It seems to be free-floating.

Chapter 12: Psychological Disorders Page 453 a.
Symptoms: i.
Motor tension (shakiness, inability to relax) ii.
Autonomic nervous system arousal (sweating, dry mouth, racing heart) iii.
Feelings of dread and foreboding. iv.
Excessive vigilance (irritability, insomnia).
4.
Obsessive-compulsive disorder a.
Obsessions are recurrent, anxiety-provoking thoughts or images that seem irrational and disrupt daily life. b.
Compulsions are thoughts or behaviors that tend to reduce the anxiety connected with obsessions. c.
Examples include irresistible urges to check things (Is the door locked?
The gas turned off?)
5.
Stress disorders a.
Posttraumatic stress disorder (PTSD) is characterized by a rapid heart rate and feelings of anxiety and helplessness that are caused by a traumatic experience. i.
Traumatic experiences include natural or man-made disasters, threats, or assault, or witnessing a death. ii.
Often seen in firefighters, combat veterans, and people whose homes and communities have been swept away by natural disasters; victims of accidents or abuse. iii.
The traumatic event is revisited in the form of intrusive memories, recurrent dreams, and flashbacks.

They try to avoid thoughts and activities connected to the event.

May find it difficult to enjoy life.

Extreme vigilance. b.
Acute stress disorder is characterized by feelings of anxiety and helplessness that are caused by a traumatic event. i.
Acute stress disorder occurs within a month of the event and lasts from
2 days to 4 weeks.

Women who have been raped often experience acute distress that tends to peak in severity a few weeks after the assault. They can go on to experience PTSD as well.
C.
Explaining Anxiety Disorders
1.
Biological views state that anxiety tends to run in families. a.
Twin studies show a higher concordance rate for anxiety disorders among identical twins than among fraternal twins. b.
The brain may not be sensitive enough to GABA, a neurotransmitter that may help calm anxiety reactions.
2.
Psychological and social perspectives a.
Learning theorists: i.
Phobias are conditioned fears that were acquired in childhood.
Observational learning also plays a role. b.
Cognitive theorists: i.
Anxiety is maintained by thinking that one is in a terrible situation and helpless to change it.

Chapter 12: Psychological Disorders ii.
They may be biased toward focusing on threats. c.
Biopsychosocial perspective: i.
May reflect the interaction of biological, psychological, and social factors.

Biological imbalances may initially trigger events, with subsequent events being triggered by a combination of all three.

Panic attacks may happen in social situations.
III.
Dissociative Disorders
A.
Definition
1.
Characterized by a separation of mental processes such as thoughts, emotions, identity, memory, or consciousness.
B.
Types of Dissociative Disorders
1.
Dissociative amnesia, dissociative fugue, dissociative identity disorder, and depersonalization. a.
Dissociative amnesia is characterized by the person suddenly being unable to recall important personal information. i.
Cannot be attributed to biological problems. ii.
The amnesia may last for hours or years. b.
Dissociative fugue is characterized by the person abruptly leaving home or work and traveling to another place, having lost all memory of his or her past. The new personality is often more outgoing than the less inhibited one. i.
Person does not report past or if so, with invented memories. c.
Dissociative identity disorder (formerly termed multiple personality disorder) is characterized by two or more identities or personalities, each with distinct traits and memories, occupying the same person. i.
Each identity may or may not be aware of the others.
C.
Explaining Dissociative Disorders
1.
Biopsychosocial factors may be involved.
2.
Learning theorists suggest that people have learned not to think about bad memories or disturbing impulses in order to avoid feelings of anxiety, guilt, or shame.
3.
Research suggests that many cases of dissociative disorders involve memories of sexual or physical abuse during childhood.
4.
Biological level, research has shown with abused children that the traumarelated dissociation observed may have a neurological basis. a.
Child abuse may lead to permanent neurochemical and structural abnormalities in parts of the brain involved in cognition and memory.
IV.
Somatoform Disorders
A.
Definition
1.
Somatoform disorders are characterized by physical problems in people, such as paralysis, pain, or a persistent belief that they have a serious disease. Yet no evidence of a physical abnormality can be found.

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B.
Types of Somatoform Disorders
1.
Conversion disorder characterized by a major change in, or loss of, physical functioning, although there are no medical findings to explain the loss of functioning. a.
The person is not faking; seems to be converting a source of stress into a physical difficulty. b.
Some people with this disorder show indifference to their symptoms (la belle indifference).
2.
Hypochondriasis is characterized by people insisting that they are suffering with a serious physical illness even though no medical evidence of illness can be found. a.
They become preoccupied with minor physical sensations and continue to believe that they are ill despite the reassurance of physicians that they are healthy. b.
They may go from doctor to doctor seeking one who will find the real cause.
3.
Body dysmorphic disorder is a disorder where people are preoccupied with a fantasized or exaggerated physical defect in their appearance. a.
They may go to extreme lengths to correct the problem. b.
They believe that others see them as deformed. c.
They may compulsively groom themselves.
C.
Explaining Somatoform Disorders
1.
There is research evidence that people who develop hypochondriasis are particularly sensitive to bodily sensations and tend to ruminate about them. a.
Some believe it is a form of self-hypnosis. b.
Hypochondriasis: people may misinterpret run-of-the-mill physical sensations. c.
Social role of personal attractiveness can contribute to dissatisfaction with one’s body. d.
Tendencies toward perfectionism may be partly inherited.
V.
Mood Disorders
A.
Definition
1.
Mood disorders are characterized by disturbance in expressed emotions generally involving sadness or elation.
B.
Types of Mood Disorders
1.
Major depression characteristics: a.
Lack of energy. b.
Loss of self-esteem. c.
Difficulty concentrating. d.
Loss of interest in activities and other people. e.
Pessimism, crying, and thoughts of suicide. f.
More intense with people experiencing major depressive disorder (MDD). i.
MDD affects 6-7% of men and about 12% of women within a given year and 1 person in 5 or 6 over the course of a lifetime. ii.
About half who have MDD also experience the following:

Chapter 12: Psychological Disorders

Poor appetite.

Serious weight loss.

Agitation (psychomotor retardation). iii.
They may also experience distorted perceptions or psychotic behaviors.
 Delusions of unworthiness, guilt for imagined wrongs, devil administering punishments, etc.
2.
Bipolar disorder is formerly known as manic-depressive disorder and is characterized by a.
Mood swings from ecstatic elation to deep depression. i.
In the manic phase, the person may show excessive excitement, silliness, and poor judgment; may engage in destroying property and giving away expensive possessions. Too restless to sit still or sleep restfully.

Rapid flight of ideas. ii.
Depression often includes sleeping more than usual and being lethargic. Individuals also tend to withdraw and experience irritability.
C.
Explaining Mood Disorders
1.
Biological perspective: a.
Depression is heritable, associated with the trait of neuroticism. b.
Genetic factors appear to be involved. i.
Twin studies suggest a powerful role for genetic factors in bipolar disorder.
2.
Psychological perspectives: a.
Learning theorists suggest that depressed people behave as though they cannot obtain reinforcement. i.
They have an external locus of control; they do not believe they can control events to obtain reinforcement. ii.
Researchers have found links between depression and learned helplessness.
 Seligman’s study: dogs were taught that they were helpless to escape an electrical shock. When they could escape, they didn’t; they had learned to be helpless.

This helplessness resembles the behavior of depressed people. b.
Cognitive factors contributing to depression include making irrational demands on themselves. i.
Depressed people tend to ruminate about feelings of depression, which prolongs the feeling. ii.
Attribution styles include internal vs. external; stable vs. unstable; and global vs. specific. People who are depressed tend to think of their situation as internal, stable, and global. They are powerless to change. iii.
Self-blame for negative events is connected with poorer functioning of the immune system. c.
Biopsychosocial perspective: i.
Biological predispositions. ii.
Attitudes.

Chapter 12: Psychological Disorders Page 457 iii.
Situations.

Reactions to stress.

Chronic strain (marital discord, financial problems, etc.). iv.
People who are depressed have lower self-esteem and are less likely to solve social problems and have less social support.
D.
Women and Depression
1.
Women are nearly twice as likely to be diagnosed with depression as men.
2.
Once assumed that this was connected to menopause, however, women still in childbearing years are more likely to encounter depression.
3.
Some have suggested that it is related to lower levels of estrogen associated with menstruation.
4.
Others have suggested that it is due to women having a greater tendency to ruminate about stresses and negative life events.
5.
There are gender stresses placed on women, such as working at a job and working in the home.
6.
Women are more likely to experience physical and sexual abuse, lower socioeconomic status, single parenthood, and sexism.
7.
Women are also more likely to help others, which adds a burden to their lives. a.
The pain may be in women, but the cause often lies in society.
E.
Suicide
1.
About 31,000 people each year take their lives in the U.S.
a.
3% of the American population considers suicide.
b.
Third or fourth leading cause of death among older teenagers.
2.
Risk factors in suicide vary.
a.
Linked to feelings of depression and hopelessness. b.
Suicidal adolescents experience four psychological problems: i.
Confusion about self.
ii.
Impulsiveness.
iii.
Emotional instability.
iv.
Interpersonal problems.
c.
Suicide attempts are more common following stressful life events.
i.
Exit events entail a loss of social support.
 Death of a parent or friend.

Divorce.
ii.
Result in psychological pain or psychache.
d.
Suicide tends to run in families.
3.
Sociocultural factors in suicide vary.
a.
Suicide is the third leading cause of death among people aged 15-24. b.
It is more common among college students than among people of the same age who do not attend college.
i.
Each year, about 10,000 college students attempt suicide c.
Older people are more likely to commit suicide. d.
One in six Native Americans has attempted suicide.
e.
One in eight Latino and Latina Americans.
f.
Three times as many females as males attempt.
g.
Four times as many males “succeed.”

Chapter 12: Psychological Disorders
4.
Myths about suicide a.
Most people who commit suicide give warnings about their intentions; they aren’t just seeking attention.
b.
Many people who commit suicide have made prior attempts. c.
Discussing suicide with a person does not prompt the person to attempt suicide. d.
Suicidal thinking is not necessarily a sign of psychosis, neurosis, or a personality disorder.
VI.
Schizophrenia
A.
Definition
1.
Schizophrenia is a severe psychological disorder that touches every aspect of a person’s life. a.
Characterized by disturbances in thought and language, perception and attention, motor activity, and mood. b.
Referred to as the worst disorder affecting people; nearly 1% of the population worldwide.
B.
Positive versus Negative Symptoms
1.
Positive symptoms are excessive and bizarre: a.
Hallucinations. b.
Delusions. c.
Looseness of association.
2.
Negative symptoms are deficiencies: a.
Lack of emotional expression. b.
Lack of motivation. c.
Loss of pleasure in activities. d.
Social withdrawal. e.
Poverty of speech.
C.
Types of Schizophrenia
1.
Paranoid type have systematized delusions and frequently related auditory hallucinations. a.
Usually the delusions are of grandeur and persecution, including jealousy.
2.
Disorganized type show incoherence, loosening of associations, disorganized behavior, disorganized delusions, fragmentary delusions or hallucinations, and flat or highly inappropriate emotional responses. a.
Often have extreme social impairment exhibiting silliness and giddiness of mood and nonsensical speech.
3.
Catatonic type show striking impairment in motor activity. a.
Slowing of activity into a stupor that may suddenly change into an agitated phase. b.
Waxy flexibility in which the person maintains positions into which he or she has been manipulated by others. c.
They may show mutism, though they report that they heard what others were saying at the time.
D.
Explaining Schizophrenia
1.
Biological perspectives

Chapter 12: Psychological Disorders Page 459 a.
Schizophrenia appears to be a brain disorder. i.
Less gray matter. ii.
Larger size of the ventricles in the brain. iii.
Smaller prefrontal regions of the cortex. iv.
Lower activity levels in the brain. v.
Loss of synapses in the region. b.
Heredity i.
Children with two schizophrenic parents have about a 35-40% chance of being diagnosed ii.
Twin studies found a 45% matching rate for identical twins; 17% among fraternal twins. c.
Other contributors i.
Complications during pregnancy and birth. ii.
Poor maternal nutrition. iii.
Born during the winter months. iv.
Alcohol abuse by the mother may impact brain structures. v.
Increased dopamine and numbers of dopamine receptors (dopamine hypothesis).
2.
Sociocultural perspectives a.
Social and cultural factors such as poverty, discrimination, and overcrowding contribute to schizophrenia. b.
Especially true among people with a genetic predisposition. c.
Rates were twice as high among those of the low socio-economic level. i.
Poor quality housing. d.
Critics point out the issue: Are schizophrenic patients influenced by these issues, or because they have schizophrenia they experience these situations? e.
Quality of parenting matters.
3.
Biopsychosocial perspective a.
Genetic factors create the predisposition, which then interacts with other factors (complications at birth, stress, quality of parenting, etc.).
E.
The Insanity Plea
1.
Based on the M’Naghten rule, which suggests that accused may not understand what he or she was doing at the time the crime was committed, did not realize it was wrong, or was succumbing to an irresistible impulse.
2.
These individuals may be found not guilty by reason of insanity.
3.
The insanity plea is used in only about 1% of cases.
VII.
Personality Disorders
A.
Definition
1.
Personality disorders are characterized by enduring patterns of behavior that are inflexible, and maladaptive. These behaviors typically impair social or personal functioning and are a source of distress to the individual or to other people.

Chapter 12: Psychological Disorders
B.
Types of Personality Disorders
1.
Paranoid personality disorder is a tendency to interpret other people’s behavior as threatening or demeaning. a.
Mistrustful of others.
2.
Schizotypal personality disorder is characterized by peculiarities of thought, perception, or behavior such as excessive fantasy and suspiciousness, feelings of being unreal, or odd usage of words.
3.
Schizoid personality is defined by indifference to relationships and flat emotional response. a.
People with this disorder are loners.
4.
Borderline personality disorder is characterized by instability in relationships, self-image, and mood, with a lack of impulse control. a.
Fear of abandonment. b.
View others as all good or all bad. c.
Moods run from anger and irritability to depression and anxiety. d.
Difficulty controlling anger and are prone to fights. e.
Destructive behavior: i.
Spending sprees and gambling. ii.
Binge eating. iii.
Shoplifting. iv.
Reckless driving. v.
Drug abuse. vi.
Engaging in unsafe sexual activity. vii.
Self-mutilate as a means to manipulate others. viii.
Also associated with suicide attempts.
5.
Antisocial personality disorder is characterized by persistently violating the rights of others and being in conflict with the law. a.
Individuals often show superficial charm. b.
They lack guilt or anxiety about their misdeeds. c.
They fail to learn from punishment. d.
They fail to form meaningful bonds with other people. e.
Women are more likely than men to have anxiety and depressive disorders. Men are more likely to have antisocial personality disorder.
6.
Avoidant personality disorder individuals are generally unwilling to enter a relationship without some assurance of acceptance because they fear rejection and criticism. a.
They do have some feelings of warmth toward other people, unlike the schizoid personality disorder.
C.
Explaining Personality Disorders
1.
Biological factors including heritability seem to influence personality disorders. a.
Possible prefrontal cortex of the brain connected with emotional responses in antisocial personality disorder.
2.
Psychological factors: learning theorists suggest that childhood experiences can contribute to maladaptive ways of relating to others in adulthood.

Chapter 12: Psychological Disorders Page 461 a.
Cognitive psychologists have found that antisocial adolescents encode social information in ways that bolster their misdeeds.
3.
Sociocultural factors: we live in a fragmented and alienating time that tends to create the problems in forming stable identities and relationships, which may contribute to borderline personality disorder.

Chapter 12: Psychological Disorders

© 2014 Wadsworth, a division of Cengage Learning
Chapter 12: Psychological Disorders Page 463
HANDOUT 12 - 1

Chapter 12: Psychological Disorders
© 2014 Wadsworth, a division of Cengage Learning
Biopsychosocial Factors of Psychological Disorders
HANDOUT 12 - 2

© 2014 Wadsworth, a division of Cengage Learning
Individuals who have experienced mood disorders:
Alanis Morissette Lionel Aldridge
Tipper Gore
Barbara Bush
Garnet Coleman
Phil Graham
Jimmie Piersall
Karl Paul Link
Ilie Natase
Alvin Ailey
Thomas Eagleton
Sol Wachtler
Kitty Dukakis
Abbie Hoffman
Muffin Specer Devlin
Steven Hawking
Bert Yancey
Dick Clark
William Faulkner
Joseph Conrad
Virginia Woolf
Cole Porter
Sting
Axl Rose
Sheryl Crow
T.S. Eliot
Anne Sexton
Michelangelo
Issac Newton
Sigmund Freud
F. Scott Fitzgerald
Eugene O’ Neil
Jules Feiffer
Hector Berlioz
Tom Waits
Ray Charles
Sara McLachlan
Sylvia Plath
Walt Whitman
Edward Munch
Abraham Lincoln
Carrie Fisher
Georgia O’Keeffe Franz Kafka
See Psychology Today article Nov/Dec 1999
Chapter 12: Psychological Disorders Page 465
HANDOUT 12 - 3
Marilyn Monroe
Lynn Rivers
Salvador Luria
Patty Duke
Robert McFarlance
Edwin E Aldrin
Francis Ford Coppola
Linda Hamilton
Drew Barrymore
Ernest Hemingway
Tennessee Williams
Irving Berlin
Kurt Cobain
Brian Wilson
Eric Clapton
Robert Schumann
Edgar Allan Poe
Vincent van Gogh
Mark Rothko
Ted Turner
Roseanne Barr

Chapter 12: Psychological Disorders
© 2014 Wadsworth, a division of Cengage Learning
Mock Diagnostic Statistical Manual of Mental Disorders
Anxiety Disorders
HANDOUT 12 - 4
Disorders that are characterized by worrying, nervousness, fear of losing control, and the inability to relax in the face of no real threat. Physical features include trembling, sweating, a pounding heart, elevated blood pressure, and faintness.
Specific Phobia
Disorder characterized by excessive, irrational fears of specific objects or situations
Social Phobia
Disorder characterized as persistent fear of scrutiny by others or of doing something that will be humiliating or embarrassing.
Agoraphobia
Disorder characterized as a fear of being out in open busy areas. Many people with this disorder tend to seclude themselves in areas where they feel safe.
Panic disorder
Disorder characterized by an abrupt attack by persistent anxiety that is not attributed to any specific object. The anxiety is free floating. It may be characterized by shakiness, inability to relax, sweating, dry mouth, etc.
Generalized Anxiety Disorder
Disorder characterized by persistent anxiety that is not attributed to any specific object. The anxiety is free floating. It may be characterized by shakiness, inability to relax, sweating, dry mouth, etc.
Obsessive-Compulsive Disorder
Disorder characterized by irresistible urges to engage in specific acts, often repeatedly, such as washing, dressing, counting, etc.
Posttraumatic Stress Disorder
Disorder characterized by a rapid heart rate and feelings of anxiety and helplessness caused by a traumatic experience such as threat, assault, destruction of one’s community, or witnessing death. It may occur months or years after witnessing an event. The traumatic event is revisited in the form of intrusive memories, recurrent dreams, and flashbacks; the sudden feeling that the event is recurring.
Dissociative Disorders
Disorders characterized by separation of mental processes such as thoughts, emotions, identity, memory, or consciousness.

Chapter 12: Psychological Disorders Page 467
Dissociative Amnesia
Disorder in which a person is suddenly unable to recall important personal information. The loss of memory cannot be attributed to organic problems, such as a blow to the head or alcoholic intoxication.
Dissociative Fugue
Disorder wherein a person abruptly leaves his or her home or place of work and travels to another place, having lost all memory of his or her past life. While at the new location, the person either does not think about the past or reports a past filled with invented memories.
Dissociative Identity Disorder
Disorder wherein an individual has two or more identities or personalities, each with distinct traits and memories that “occupy” the person. Each identity may or may not be aware of the others.
Depersonalization Disorder
Disorder characterized by persistent or recurrent feelings that one is detached from one’s own body as if one is observing his or her thought process from the outside.
Somatoform Disorders
Sufferers complain of physical problems such as paralysis, pain, or a persistent belief that they have a serious disease
Conversion Disorder
Disorder characterized by a major change in, or loss of, physical functioning although no medical findings can explain the loss of the functioning. The individual is not faking. The person “converts” the source of stress into a physical disability.
Hypochadriasis
Disorder in which sufferers insist they have a serious physical illness even though no medical evidence can be found. They become preoccupied with minor physical sensations and continue to believe that they are ill despite the reassurance of physicians that they are healthy.
Mood Disorders
Disorders characterized by disturbance in expressed emotions. The disruption generally involves sadness or elation
Major Depression
Disorder characterized by extreme feelings of sadness. Symptoms may include poor appetite, serious weight loss, agitation, or great lethargy. Sufferers may be unable to concentrate and make decisions.
There may also be delusions or hallucinations. Suicidal thoughts may also be present.
Bipolar Disorder
The person undergoes wide mood swings, from ecstatic elation to deep depression. These cycles seem unrelated to external events. In the manic phase, the person may show excessive excitement or silliness, carrying jokes too far, argumentativeness, poor judgment, destroying property, making huge contributions to charity, or giving away an expensive possession. When the person is in the depressive stage, he or she sleeps more, is lethargic. The person may also exhibit social withdrawal and irritability.

Chapter 12: Psychological Disorders
Schizophrenia
A severe psychological disorder characterized by disturbances in thought and language, perceptions and attention, motor activity, mood, and withdrawal and absorption in daydreams or fantasy. Many times, schizophrenics suffer from delusions, hallucinations, and inappropriate emotions.
Paranoid Schizophrenia
These people have systematic delusions and frequently related auditory hallucinations. They usually have delusions of grandeur and persecution, but they may also have delusions of jealousy in which they believe that a spouse or lover has been unfaithful. They may show agitation, confusion, and fear, and may experience vivid hallucinations consistent with their delusions.
Disorganized Schizophrenia
Sufferers show incoherence, loosening of associations, disorganized behavior, disorganized delusions, fragmentary delusions or hallucinations, and flat or highly inappropriate emotional responses. Extreme social impairment is common. People with this type of schizophrenia may also exhibit silliness and giddiness of mood, giggling, and nonsensical speech. They may neglect their appearance and personal hygiene, and lose control of their bladder and bowels.
Catatonic Schizophrenia
People with this disorder show striking impairment in motor activity. It is characterized by a slowing of activity into a stupor that may suddenly change into an agitated phase. Catatonic individuals may maintain unusual even difficult postures for hours, even as their limbs grow swollen or stiff.
Personality Disorders
Disorders characterized by enduring patterns of behavior. The disorders are inflexible and maladaptive. They impair personal or social functioning and are the source of distress to the individual or to others.
Paranoid Personality Disorder
People with this disorder have a tendency to interpret other people’s behavior as threatening or demeaning; however, they do not show the grossly disorganized thinking of paranoid schizophrenia.
They are mistrustful of others and may be suspicious of coworkers and supervisors, but they can generally hold a job.
Schizoid Personality Disorder
This disorder is defined by indifference to relationships and flat emotional response. People with this disorder are loners. They do not develop warm, tender feelings for others.
Antisocial Personality Disorder
People who have this disorder persistently violate the rights of others and are often in conflict with the law. They often show a superficial charm and are at least average in intelligence. The predominant characteristic is their lack of guilt or anxiety about their misdeeds and their failure to learn from punishment or to form meaningful bonds with other people.
Avoidant Personality Disorder
This disorder is defined by a general unwillingness to enter into relationships without some assurance of acceptance, because sufferers fear rejection and criticism. They usually have very few

Chapter 12: Psychological Disorders Page 469 close relationships. However, unlike schizoid personality disorder, they have some interest in, and feelings of warmth toward, other people.
Eating Disorders
Class of disorders characterized by persistent, gross disturbances in eating patterns
Anorexia Nervosa
A life-threatening disorder characterized by refusal to maintain a healthful body weight, intense fear of being overweight, a distorted body image, and, in women, a lack of menstruation. Behaviors may include fasting, vomiting, excessive use of laxatives, or excessive exercise.
Bulimia Nervosa
Disorder characterized by recurrent cycles of binge eating followed by dramatic measures to purge the food. Binge eating frequently follows food deprivation. Purging includes self-induced vomiting, fasting or strict dieting, use of laxatives, and vigorous exercise.