Chapter 16
Psychological Disorders
Quiz
1. Social nonconformity is the failure to conform to
societal norms or the usual minimum standards for
social conduct, culturally specific.
2. Mood disorder is a major disturbance in mood or
emotion, such as depression or mania or bipolarity.
3. Schizophrenia means having a split personality
4. Everyone who experiences the same traumatic
event will experience PTSD.
5. Once someone is diagnosed with a major mental
health disorder, they are considered crazy and there
is not much that can be done to help them.
What is Normal?
• Psychopathology: Scientific study of mental,
emotional, and behavioral disorders; abnormal
or maladaptive behavior
• Subjective Discomfort: Subjective feelings of
pain, unhappiness, or emotional distress
• Statistical Abnormality: Having extreme scores
on some dimension, such as intelligence,
anxiety, or depression
What is Normal? Continued
• Social Nonconformity: Disobeying societal
standards for normal conduct; usually leads to
destructive or self-destructive behavior
• Situational Context: Social situation, behavioral
setting, or general circumstances in which an
action takes place
– Is it normal to walk around strangers naked?
If you are in a locker room and in the shower
area, yes!
Cultural Relativity
• Prepare a list of normal behaviors that involve
interacting with other people
• Who are they normal or abnormal for?
• A man? A woman? A culture emphasizing
passivity? A culture emphasizing aggression?
• Judgments are made relative to the values of
one’s culture
Fig. 16-1, p. 533
Statistical Abnormality
• Estimate the number of parties you have attended in the
last month.
• Estimate the number of hours you have spent watching
TV or using the computer (not for homework) in the last
week
• Estimate the number of hours you have spent with your
family in the last week
• What should define compulsive partying? Or other
compulsive behavior?
• What is the cutoff for being addicted to any of these
behaviors?
Fig. 16-2, p. 536
Clarifying and Defining Abnormal Behavior
(Mental Illness)
• Maladaptive Behavior: Behavior that makes it
difficult to function, to adapt to the environment,
and to meet everyday demands
• Mental Disorder: Significant impairment in
psychological functioning
• Those with mental illness lose the ability to
adequately control thoughts, behaviors, or
feelings
p. 533
General Risk Factors for Contracting
Mental Illness
• Social Conditions: Poverty, homelessness,
overcrowding, stressful living conditions
• Family Factors: Parents who are immature,
mentally ill, abusive, or criminal; poor child
discipline; severe marital or relationship
problems
• Psychological Factors: Low intelligence, stress,
learning disorders
• Biological Factors: Genetic defects or inherited
vulnerabilities; poor prenatal care, head injuries,
exposure to toxins, chronic physical illness, or
disability
Insanity
• Definition: A legal term; refers to an inability to
manage one’s affairs or to be aware of the
consequences of one’s actions
– Those judged insane (by a court of law) are
not held legally accountable for their actions
– Can be involuntarily committed to a
psychiatric hospital
– Some movements today are trying to abolish
the insanity plea and defense; desire to make
everyone accountable for their actions
– How accurate is the judgment of insanity?
Insanity
• How do you define insanity?
• DSM-IV TR definition: Interferes with daily functioning on
the following 2 out of 5 of the following categories.
• (page 312)
• Legal Defense: When an accused person in a criminal
prosecution to avoid liability for the commission of a
crime because, at the time of the crime, the person did
not appreciate the nature or quality or wrongfulness of
the acts.
Antisocial Personality Disorder (APD)
• A person who lacks a conscience (superego?);
typically emotionally shallow, impulsive, selfish,
and manipulative toward others
– Oftentimes called psychopaths or sociopaths
• Many are delinquents or criminals, but many are
NOT crazed murderers displayed on television
• Create a good first impression and are often
charming
• Cheat their way through life (e.g., Scott
Peterson)
APD: Causes and Treatments
• Possible Causes:
– Childhood history of emotional deprivation,
neglect, and physical abuse
– Underarousal of the brain
• Very difficult to effectively treat; will likely lie,
charm, and manipulate their way through
therapy
Anxiety-Based Disorders
• Anxiety: Feelings of apprehension, dread, or
uneasiness
• Adjustment Disorders: When ordinary stress
causes emotional disturbance and pushes
people beyond their ability to effectively cope
– Usually suffer sleep disturbances, irritability,
and depression
– Examples: Grief reactions, lengthy physical
illness, unemployment
Panic Disorder without Agoraphobia
• A chronic state of anxiety with brief moments of
sudden, intense, unexpected panic (panic
attack)
– Panic Attack: Feels like one is having a heart
attack, going to die, or is going insane
– Symptoms include vertigo, chest pain,
choking, fear of losing control
Specific Phobias
• Irrational, persistent fears, anxiety, and
avoidance that focus on specific objects,
activities, or situations
• People with phobias realize that their fears are
unreasonable and excessive, but they cannot
control them
Obsession
• Recurring images or thoughts that a person cannot
prevent
– Cause anxiety and extreme discomfort
– Enter into consciousness against the person’s will
– Most common: Being dirty, wondering if you
performed an action (turned off the stove), or violence
(hit by a car)
– Obsessive-Compulsive Disorder (OCD) : Extreme
preoccupation with certain thoughts and compulsive
performance of certain behaviors
Compulsion
• Irrational acts that person feels compelled to
repeat against his/her will
– Help to control anxiety created by obsessions
– Checkers and cleaners
Stress Disorders
• Occur when stresses outside range of normal
human experience cause major emotional
disturbance
– Symptoms: Reliving traumatic event
repeatedly, avoiding stimuli associated with
the event, and numbing of emotions
Acute Stress Disorder
• Psychological disturbance lasting up to one
month following stresses from a traumatic event
• What does a nervous breakdown look like?
• What has broken down?
• What nerves are being referred to?
Post Traumatic Stress Disorder (PTSD)
• Lasts more than one month after the traumatic
event has occurred; may last for years
– Typically associated with combat and violent
crimes (rape, assault, etc.)
– Terrorist attacks on September 11th, 2001,
likely led to an increase of PTSD
Dissociative Disorders
• Dissociative Amnesia: Inability to recall one’s
name, address, or past
• Dissociative Fugue: Sudden travel away from
home and confusion about personal identity
– Usually triggered by highly traumatic events
Split Personality
•
•
•
•
What does split personality mean?
What is split?
What would it look like?
How would you treat it?
Dissociative Identity Disorder (DID)
• Person has two or more distinct, separate
identities or personality states; previously known
as Multiple Personality Disorder
– “Sybil” or “The Three Faces of Eve” are good
examples
– Often begins with horrific childhood
experiences (e.g., abuse, molestation, etc.)
– Therapy often makes use of hypnosis
– Goal: Integrate and fuse identities into single,
stable personality
Hypochondriasis
• Person is preoccupied with having a serious
illness or disease
– Interpret normal sensations and bodily signs
as proof that they have a terrible disease
– No physical disorder can be found
Somatization Disorder
• Person expresses anxieties through numerous
physical complaints
– Many doctors are consulted but no organic or
physical causes are found
Glove Anesthesia
• Loss of skin sensitivity in areas normally covered
by a glove
Theoretical Causes of Anxiety Disorders:
Psychodynamic (Freud)
• Anxiety caused by conflicts among id, ego, and
superego
– Forbidden id impulses for sex or aggression
are trying to break into consciousness and
thus influence behavior; person fears doing
something crazy or forbidden
– Superego creates guilt in response to these
impulses
– Ego gets overwhelmed and uses defense
mechanisms to cope
Psychosis
• Loss of contact with shared views of reality
• Delusions: False beliefs that individuals insist
are true, regardless of overwhelming evidence
against them
Hallucinations
• Imaginary sensations, such as seeing, hearing,
or smelling things that do not exist in the real
world
– Most common psychotic hallucination is
hearing voices
– Note that olfactory hallucinations sometimes
occur with seizure disorder (epilepsy)
Some More Psychotic Symptoms
• Flat Affect: Lack of emotional responsiveness;
face is frozen in blank expression
• Disturbed Verbal Communication: Garbled and
chaotic speech; word salad
• Personality Disintegration: When an individual’s
thoughts, actions, and no longer connected
Other Psychotic Disorders
• Organic Psychosis: Psychosis caused by brain
injury or disease
– Dementia: Most common organic psychosis;
serious mental impairment in old age caused
by brain deterioration
– Archaically known as senility
Alzheimer’s Disease
• Symptoms include impaired memory, mental
confusion, and progressive loss of mental
abilities
– Ronald Reagan most famous Alzheimer’s
victim
p. 551
Fig. 16-5, p. 550
Delusional Disorders
• Marked by presence of deeply held false beliefs
(delusions)
– May involve delusions of grandeur,
persecution, jealousy, or somatic delusions
– Experiences could really occur!
• Paranoid Psychosis: Most common delusional
disorder
– Centers on delusions of persecution
Schizophrenia: The Most Severe Mental
Illness
• Psychotic disorder characterized by
hallucinations, delusions, apathy, thinking
abnormalities, and “split” between thoughts and
emotions
– Does NOT refer to having split or multiple
personalities
Four Subtypes of Schizophrenia
• Disorganized: Incoherence, grossly disorganized
behavior, bizarre thinking, and flat or grossly
inappropriate emotions
• Catatonic: Marked by stupor, unresponsiveness,
posturing, mutism, and sometimes, by agitated,
purposeless behavior
• Paranoid type: Preoccupation with delusions; also
involves auditory hallucinations that are related to a
single theme, especially grandeur or persecution
• Undifferentiated: Any type of schizophrenia that does not
have specific paranoid, catatonic, or disorganized
features or symptoms
p. 553
Causes of Schizophrenia
• Psychological Trauma: Psychological injury or
shock, often caused by violence, abuse, or
neglect
• Disturbed Family Environment: Stressful or
unhealthy family relationships, communication
patterns, and emotional atmosphere
• Deviant Communication Patterns: Cause guilt,
anxiety, anger, confusion, and turmoil
p. 556
p. 556
p. 556
p. 556
Fig. 16-6, p. 554
Biochemical Causes of Schizophrenia
• Biochemical Abnormality: Disturbance in brain’s
chemical systems or in the brain’s
neurotransmitters
• Dopamine: Neurotransmitter involved with
emotions and muscle movement
– Works in limbic system
• Dopamine overactivity in brain may be related to
schizophrenia
• Glutamate: A neurotransmitter; may also be
involved
Fig. 16-7, p. 555
Fig. 16-8, p. 556
Schizophrenic Brain Images
• Computed Tomography (CT) Scan: Computer
enhanced X-ray of brain or body
• Magnetic Resonance Imaging (MRI) Scan:
Computer enhanced three-dimensional image of
brain or body; based on magnetic field
– MRIs show schizophrenic brains as having
enlarged ventricles
Stress-Vulnerability Model
• Combination of environmental stress and
inherited susceptibility cause schizophrenic
disorders
Mood Disorders
• Major disturbances in emotion, such as
depression or mania
• Depressive Disorders: Sadness or despondency
are prolonged, exaggerated, or unreasonable
• Bipolar Disorders: Involve both depression and
mania or hypomania
• Dysthymic Disorder: Moderate depression that
lasts for at least two years
• Cyclothymic Disorder: Moderate manic and
depressive behavior that lasts for at least two
years
Major Mood Disorders
• Lasting extremes of mood or emotion and
sometimes with psychotic features
(hallucinations, delusions)
• Major Depressive Disorder: A mood disorder
where the person has suffered one or more
intense episodes of depression; one of the more
serious mood disorders
Bipolar Disorders
• Bipolar I Disorder: Person experiences extreme
mania and deep depression
– Mania: Excited, hyperactive, energetic,
grandiose behavior
• Bipolar II Disorder: Person is mainly sad but has
one or more hypomanic episodes (mild mania)
Postpartum Depression
• Moderately severe depression that begins within
three months following childbirth
– Marked by mood swings, despondency,
feelings of inadequacy, and an inability to
cope with the new baby
– May last from two months to one year
– Part of the problem may be hormonal
Seasonal Affective Disorder (SAD)
• Depression that only occurs during fall and
winter
– May be related to reduced exposure to
sunlight
– Phototherapy: Extended exposure to bright
light to treat SAD
Fig. 16-12, p. 561
Other Psychological Disorders
• Substance Related Disorders: Abuse or
dependence on a mind- or mood-altering drug,
like alcohol or cocaine
– Person cannot stop using the substance and
may suffer withdrawal symptoms if they do
• Sexual and Gender Identity Disorder: Problems
with sexual identity, deviant sexual behavior, or
sexual adjustment
• Neurosis: Archaic; once used to refer to anxiety,
somatoform, dissociative disorders, and to some
forms of depression (as a whole group)
Mentally Healthy?
What does it mean to be mentally healthy?
What are the basic attributes?
How can we discuss psychopathology (problems)
without a thorough understanding of health?
For example: Jahoda’s list:
Accurate self concept, self awareness and self
acceptance
Self actualization, full use of potential
Autonomy
Integration, a coherent outlook on life
Accurate perceptions of reality and social
sensitivity
Competence and mastery of the environment
Deviant Behavior
• You get the chance to observe deviant behavior in
action.
• In groups of 3, one of you will be the deviant behaver,
and the other 2 will be the observers.
• Go out in the building, or surrounding areas and do
something that is not “normal”
• The observers will report how your behavior was
responded to by other people
• Don’t do anything entirely inappropriate, offensive or that
would get yourself or me into trouble
• See page 533 in your textbooks for an example
Deviant Discussion
•
•
•
•
Reactions of the unsuspecting to the “deviant”
Negative sanctions applied by the subjects
Feelings of students before, during and after event
What does it mean to be normal or abnormal? Are your
thoughts different now than they were in the beginning of
class?
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