Psychological Disorders
Chapter 18: Psychological Disorders
Case Study: Not Guilty by Reason of Insanity
Section 1: Understanding Psychological Disorders
Section 2: Anxiety and Mood Disorders
Section 3: Dissociative and Somatoform Disorders
Section 4: Schizophrenia
Section 5: Personality Disorders
Lab: Applying What You’ve Learned
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Psychological Disorders
Case Study: Not Guilty by Reason of Insanity
The majority of people with serious psychological disorders
are not dangerous to others. Some, however, commit
violent crimes. Of these, some are found not guilty by
reason of insanity and are sent to psychiatric institutions
instead of prison. When an accused person pleads insanity,
the prosecutor tries to prove that the person was sane at
the time of the crime and the defense tries to prove he or
she was not. Under law, one must be either all or nothing,
but in reality most psychological disorders are a matter of
degree.
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Psychological Disorders
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Psychological Disorders
What do you think?
• In general, what criteria must a defendant meet to be
ruled legally insane?
• Do you support the use of the insanity defense? Why
or why not?
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Psychological Disorders
Section 1 at a Glance
Understanding Psychological Disorders
• Psychological disorders are behavior patterns or mental
processes that cause serious personal suffering or
interfere with a person’s ability to cope with everyday life.
• Psychological disorders are classified in the Diagnostic
and Statistical Manual of Mental Disorders, also known
as the DSM.
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Psychological Disorders
Understanding Psychological Disorders
Main Idea
Psychological disorders are relatively common. They cause personal
suffering to millions of people and interfere with their ability to cope with
everyday life.
Reading Focus
• What are psychological disorders, and how common are they?
• What are the four major symptoms that can help identify
psychological disorders?
• How do psychologists classify psychological disorders?
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Psychological Disorders
Why were people with
mental illnesses seen
as criminals?
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Psychological Disorders
What Are Psychological Disorders?
• Psychological disorders are behavior patterns or mental processes
that cause serious personal suffering or interfere with a person’s
ability to cope with everyday life.
• The great majority of people are never admitted to mental hospitals
and most people never seek the help of psychologists or
psychiatrists.
• Estimates suggest that one in four American adults have experienced
some type of psychological disorder.
• For people aged 15 to 44, psychological disorders are the leading
cause of disability in the United States.
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Psychological Disorders
Reading Check
Summarize
What is a common misconception about
psychological disorders?
Answer: Psychological disorders are uncommon.
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Psychological Disorders
Click on the
image to play
the Interactive.
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Psychological Disorders
Identifying Psychological Disorders
• People with psychological disorders usually do not differ much form
so-called normal people.
• Certain behavior patterns and mental processes may suggest that an
individual has a psychological disorder.
• Psychologists use several criteria to determine whether a person’s
behavior indicates the presence of a psychological disorder.
Typicality
• Normality is determined by the degree to which a behavior is
average, or typical, of the majority of people.
– Scientific and artistic geniuses are not typical, but are not abnormal.
– People who are quite normal may have lifestyles that differ widely from
the rest of the community.
• Additional measurements must be taken into account.
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Psychological Disorders
Maladaptivity
• Maladaptivity is a behavior that impairs an individual’s ability to
function adequately in everyday life.
• Behavior that causes misery and distress rather than
happiness and fulfillment, or that is dangerous
Emotional Discomfort
• Depression and anxiety cause extreme emotional discomfort.
• Helplessness, hopelessness, worthlessness, guilt, extreme
sadness, and withdrawal
Socially Unacceptable Behavior
• Cultural context of a behavior must be taken into account.
• Culture-bound syndromes: clusters of symptoms
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Psychological Disorders
Reading Check
Find the Main Idea
What are four features that might indicate a
psychological disorder?
Answer: The four features are typicality,
maladaptivity, emotional discomfort, and socially
unacceptable behavior.
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Psychological Disorders
Classifying Psychological Disorders
Classification helps to determine:
• How many people have a given disorder
• What factors may be associated with a disorder
• Diagnosis and treatment
DSM
Major Types of Disorders
• APA's classification system
• Anxiety
• Used to communicate needs
and treatment
• Mood
• Modern categories based on
observable signs and symptoms
• Somatoform
• Dissociative
• Schizophrenic
• Personality
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Psychological Disorders
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Psychological Disorders
Reading Check
Summarize
What are some ways in which the DSM has
been revised?
Answer: disorders are no longer organized by
presumed causes, categories have been added
and removed, and the number of psychological
disorders has grown
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Psychological Disorders
Cultural Diversity and Psychology
Culture-Bound Syndromes
In certain cultures, one can find combinations of psychiatric and physical
symptoms recognized as disease only in that culture. These are often treated
with folk remedies.
• Hikikomori: Japanese people who
have withdrawn from social life
• Latah: In Malaysia, a person who
has a severe reaction to being
startled. When surprised, latahs
mimic the speech of those around
them and obey any order
• Ghostsickness: Navajo illness with
symptoms of bad dreams, loss of
appetite, feeling of suffocation,
hallucinations, fainting, and terror
• Hwa-byung: In Korea, a name for
physical symptoms that arise from
the suppression of anger
• Amok: In Malaysia, a previously
peaceful man who suddenly tries to
kill or injure others
• Susto: some Hispanics; the
experience of acute unhappiness
following a frightening event
• Zar: Middle East and North Africa,
women laugh and bang heads
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Psychological Disorders
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Psychological Disorders
Thinking Critically
• What are some of the physical symptoms associated with
culture-bound syndromes?
• Do you think Western medical schools should include
culture-bound syndromes in their psychiatry programs?
Why or why not?
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Psychological Disorders
Section 2 at a Glance
Anxiety and Mood Disorders
• Anxiety disorders occur when people feel fear or
nervousness out of proportion to the actual threat.
• Mood disorders are characterized by mood changes that
are inappropriate for the situation to which they are
responding.
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Psychological Disorders
Anxiety and Mood Disorders
Main Idea
Anxiety disorders cause people to experience irrational or excessive
fear. Mood disorders cause people to experience mood changes that
are inappropriate to the situation.
Reading Focus
• What are some characteristics of anxiety?
• What are five major types of anxiety disorders?
• How do psychologists explain anxiety disorders?
• How do the two main types of mood disorders compare?
• Which theories explain the origins of mood disorders?
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Psychological Disorders
Why does an English
soccer star need
three refrigerators?
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Psychological Disorders
What Is Anxiety?
• Anxiety refers to a generalized state of dread or uneasiness that
occurs in response to a vague or imagined danger, as opposed to
fear, which is a response to a real danger or threat.
– Characterized by
• Nervousness
• Inability to relax
• Concern about losing control
• Trembling
• Sweating
• Rapid heart rate
• Shortness of breath
• Increased blood pressure
• Everyone feels anxious at times, but constant anxiety can interfere
with effective living.
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Psychological Disorders
Reading Check
Analyze
How are anxiety disorders different from
normal anxious reactions?
Answer: constant anxiety, out of proportion to
event, interferes with normal effective living
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Psychological Disorders
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Psychological Disorders
Types of Anxiety Disorders
Phobic Disorder
• Phobia: derives from the Greek root phobos, which means “fear”
• Specific phobia is the most common of all anxiety disorders and
refers to a persistent excessive fear of a particular object or situation.
– Most common include
• Zoophobia: fear of animals
• Claustrophobia: fear of enclosed spaces
• Acrophobia: fear of heights
• Arachnophobia: fear of spiders
• Social phobia is characterized by persistent fear of social situations
in which one might be exposed to the scrutiny of others.
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Psychological Disorders
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Psychological Disorders
Panic Disorder and Agoraphobia
• People with panic disorder have recurring and unexpected panic
attacks, or relatively short periods of intense fear or discomfort
characterized by shortness of breath, dizziness, rapid heart rate,
trembling, choking, etc.
• Agoraphobia: the fear of being in places or situations in which
escape may be difficult or impossible such as crowded public places.
– Many people with agoraphobia develop panic attacks when in public.
Generalized Anxiety Disorder
• An excessive or unrealistic worry about life circumstances that lasts
for at least six months.
– Few people seek treatment because it does not differ, except in intensity
and duration, from the normal worries of everyday life.
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Psychological Disorders
Obsessive-Compulsive Disorder (OCD)
• Obsessions are unwanted thoughts, ideas, or mental images that
occur over and over again, and most people try to ignore or suppress
them.
• Compulsions are repetitive ritual behaviors, often involving checking
or cleaning something.
• People are usually aware that the obsessions are unjustified, which
distinguishes obsessions from delusions.
Stress Disorders
• Include post-traumatic stress disorder (PTSD) and acute stress
disorder
– Similar symptoms, but PTSD is more severe and longer-lasting
– PTSD occurs after rape, abuse, severe accident, natural disasters, and
war atrocities.
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Psychological Disorders
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Psychological Disorders
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Psychological Disorders
Reading Check
Summarize
What are the five types of anxiety disorders?
Answer: phobic, panic, generalized anxiety,
obsessive-compulsive, stress
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Psychological Disorders
Explaining Anxiety Disorders
Psychological Views
Biological Views
• Psychoanalytic views are no longer
widely accepted, but have affected
the classification of psychological
disorders.
• Heredity may play a role
• Learning theorists believe that
phobias are learned in childhood.
• Cognitive theorists believe that
people make themselves feel
anxious by responding negatively
to most situations.
• Studies of twins indicate that
having a parent or sibling with a
disorder increases the chance an
individual will have a disorder.
• Some psychologists believe that
people who rapidly acquired strong
fears of real dangers would be
more likely to live and reproduce.
Interaction of Factors: some cases reflect the interaction of biological
and psychological factors.
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Psychological Disorders
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Psychological Disorders
Reading Check
Find the Main Idea
How do learning theorists explain anxiety
disorders?
Answer: Phobias are learned in childhood, conditioned
phobias remain; people avoid situations that lead to anxiety
related to the phobia.
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Psychological Disorders
Types of Mood Disorders
• Most people have mood changes
that reflect the normal ups and
downs of life, but mood changes
that are inappropriate to a situation
can signal a mood disorder.
Major Depression
• Two types: depression and
bipolar disorder
• The DSM-IV contains a list of
symptoms to help diagnose
Bipolar Disorder
Postpartum Depression
• A cycle of mood changes from
depression to wild elation and back
again
• Some women suffer symptoms of
depression after giving birth
• Feelings of helplessness,
hopelessness, worthlessness, guilt,
and great sadness
• Can harm both mother and child
• Period of mania, or extreme
excitement characterized by
hyperactivity and chaotic behavior
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Psychological Disorders
Reading Check
Analyze
What are some ways that mood disorders
can disrupt one’s daily life?
Answer: persistent depressed mood, loss of
interest in activities, significant weight loss or gain,
sleeping more or less, fatigue, reduced ability to
concentrate or make meaningful decisions,
recurrent thoughts of death or suicide
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Psychological Disorders
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Psychological Disorders
Explaining Mood Disorders
• Psychological Views
– The psychoanalytic view of depression connects the past to the present.
– Learning theorists: “learned helplessness” makes people prone.
– Cognitive theorists: habitual style of explaining life events.
• Attribution theory: people assign different types of explanations to events,
which affect self-esteem and self-efficacy.
• Beck suggests that people who are depressed have a negative view of
themselves, their experiences, and their future.
• Biological Views
– Mood disorders occur more often in the close relatives of affected
individuals than they do in the general population.
– Two neurotransmitters in the brain—serotonin and noradrenaline—may
partly explain the connection between genes and mood.
• Biological and Psychological Factors
– A combination of factors is most likely at work.
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Psychological Disorders
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Psychological Disorders
Reading Check
Explain
How was Martin Seligman’s experiment with
dogs related to theories about mood
disorders?
Answer: Dogs learned that they could not prevent
the pain of shocks. Theorists have applied this to
human beings, suggesting that once people
believe that they cannot change a situation, they
will make no effort to do so.
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Psychological Disorders
Current Research in Psychology
Post-Traumatic Stress Disorder and Iraq War Veterans
For those who survive the horrors of war, the trauma of combat may not be left
behind on the battlefield. Some veterans report vivid flashbacks and
nightmares.
• A high incidence of PTSD has been
reported among soldiers returning
from war in Iraq and Afghanistan.
• Currently veterans can receive five
years of free health care for any
mental disorder related to combat.
• Researchers are seeking reasons
for what some call a PTSD
epidemic.
• Because PTSD shows up long after
the trauma, increased mental
health services will be necessary.
• Younger veterans are more likely to
be diagnosed.
• Those with traumatic head injuries
more likely to be diagnosed.
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Psychological Disorders
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Psychological Disorders
Thinking Critically
• Why do you think younger veterans are more likely to be
diagnosed with PTSD?
• Given the current research on PTSD, what steps do you
think the U.S. Department of Veterans Affairs should take
to deal with the effects of PTSD in returning soldiers?
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Psychological Disorders
Section 3 at a Glance
Dissociative and Somatoform Disorders
• Dissociative disorders are characterized by the
separation of certain personality components or mental
processes from conscious thought.
• Somatoform disorders are expressed in the form of actual
physical symptoms.
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Psychological Disorders
Dissociative and Somatoform Disorders
Main Idea
Dissociative disorders cause people to lose their memory or identity.
Somatoform disorders cause people to express psychological distress
through physical symptoms.
Reading Focus
• What is dissociation, and what are the four dissociative disorders?
• How do theorists explain the origins of dissociative disorders?
• What is somatization, and what are the most common types of
somatoform disorders?
• How do theorists explain the origins of somatoform disorders?
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Psychological Disorders
How could a man
forget his entire life?
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Psychological Disorders
Dissociative Disorders
• Dissociation: the separation of certain personality components or
mental processes from conscious thought
• In some situations, it is normal (becoming engrossed in a book).
• If dissociation occurs as a way to avoid stressful events or feelings, it
can signal a disorder.
Dissociative Amnesia
• Characterized by a sudden loss of memory, usually following a
particularly stressful or traumatic event.
• It cannot be explained biologically.
• The incidence of dissociative amnesia rises markedly during wartime
and natural disasters.
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Psychological Disorders
Dissociative Fugue
• Characterized by not only forgetting personal information and
past events but also by suddenly relocating from home or work
and taking on a new identity.
• Individuals may appear healthy until the fugue ends, when they
will not remember anything that happened during the fugue.
Dissociative Identity Disorder
• Involves the existence of two or more personalities within a single
individual. The various personalities may or may not be aware of
the other.
Depersonalization Disorder
• Depersonalization: feelings of detachment from one’s mental
processes or body
• People describe being outside their bodies.
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Psychological Disorders
Reading Check
Compare
What is the basic feature that dissociative
disorders have in common?
Answer: involve separation of personality
components or mental processes from conscious
thought
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Psychological Disorders
Explaining Dissociative Disorders
• Psychoanalytic theory suggests people dissociate in order to repress
unacceptable urges.
• Learning theorists claim individuals have learned not to think about
disturbing events in order to avoid feelings, of guilt, shame, or pain.
• Cognitive and biological theorists have not offered a complete
explanation of dissociative disorders.
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Psychological Disorders
Reading Check
Summarize
Which type of theories can explain
dissociative disorders?
Answer: learning theory
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Psychological Disorders
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Psychological Disorders
Somatoform Disorders
Somatization: the expression of psychological distress through
physical symptoms. People with somatoform disorders have
psychological problems (such as depression) but experience
inexplicable physical symptoms (such as paralysis).
Conversion Disorder
Hypochondriasis
• Patients experience a change in
or loss of physical functioning in
a major part of the body for
which there is no known
medical explanation
• A person’s unrealistic
preoccupation with thoughts
that he or she has a serious
disease.
• Patients often show a lack of
concern for their symptoms.
• Patients may become absorbed
by minor physical symptoms
and sensations.
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Psychological Disorders
Reading Check
Summarize
What are the two main types of somatoform
disorders?
Answer: conversion disorder, hypochondriasis
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Psychological Disorders
Explaining Somatoform Disorders
• Explanations are primarily psychological.
• Psychoanalytic theory suggests disorders occur when
individuals repress emotions associated with forbidden urges
and instead express them symbolically in physical symptoms.
• Other psychologists have argued that people with conversion
disorder “convert” psychological stress into actual medical
problems.
• Behavioral theorists have suggested that somatoform
symptoms can serve as a reinforcer if they successfully allow a
person to escape from anxiety.
• There is some evidence that biological or genetic factors may
play a role.
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Psychological Disorders
Reading Check
Analyze
What does it mean to convert psychological
stress into an actual physical problem?
Answer: Possible answer—The mind can have a
powerful effect on the body.
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Psychological Disorders
Section 4 at a Glance
Schizophrenia
• Schizophrenia is usually considered the most serious
psychological disorder and can be very disabling.
• Schizophrenia is characterized by a loss of contact with
reality.
• The three types of schizophrenia are paranoid,
disorganized, and catatonic schizophrenia.
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Psychological Disorders
Schizophrenia
Main Idea
Schizophrenia is the most serious psychological disorder, causing
thought disruption and a decreased ability to function normally.
Reading Focus
• What are the basic symptoms of schizophrenia?
• What are the three major types of schizophrenia?
• How do psychological and biological explanations of schizophrenia
differ?
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Psychological Disorders
What can paintings
of cats reveal about
a human mind?
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Psychological Disorders
What Is Schizophrenia?
• Schizophrenia: characterized by loss of contact with reality.
– Can be very disabling and can lead to the affected person’s inability to
function independently
– First appears in young adulthood
– Usually develops gradually, but can also appear suddenly
• Most striking symptoms are:
– Hallucinations
– Delusions
– Thought disorders
• Other symptoms include social withdrawal, impaired social skills, loss
of normal emotional responses.
• Occasionally, may go into a catatonic stupor: an immobile,
expressionless, comalike state.
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Psychological Disorders
Reading Check
Summarize
What is the basic characteristic of
schizophrenia?
Answer: loss of contact with reality
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Psychological Disorders
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Psychological Disorders
Types of Schizophrenia
Paranoid Schizophrenia
• Delusions or frequent auditory hallucinations that center on one
theme, often a theme of persecution
Disorganized Schizophrenia
• Incoherent in their thought and speech and disorganized in their
behavior; delusions and hallucinations are unconnected
• Emotionless or show inappropriate emotions
Catatonic Schizophrenia
• Activity may slow to a stupor and then suddenly switch to
agitation
• May hold unusual, uncomfortable body positions for long periods
of time, even after their arms and legs swell and stiffen
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Psychological Disorders
Reading Check
Summarize
What are the three types of schizophrenia?
Answer: paranoid, disorganized, and catatonic schizophrenia
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Psychological Disorders
Explaining Schizophrenia
Psychological Views
• Result of overwhelming of the ego by urges from the id.
• Fantasies become confused with reality.
• Family environment may spur disease, but does not cause it.
Biological Views
• Studies try to link abnormal brain functioning and structure with
specific symptoms.
• Heredity, complications during pregnancy and birth, and birth
during winter were all shown to affect rates of schizophrenia.
Multifactorial Model
• Biological and psychological factors may interact in development.
• The model suggests that even severely dysfunctional
environmental factors are not enough to lead to the disease.
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Psychological Disorders
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Psychological Disorders
Reading Check
Analyze
What are some indications that
schizophrenia has a physical basis?
Answer: evidence of differences in size and structure of the
brain, more dopamine use, genetic factors
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Psychological Disorders
Section 5 at a Glance
Personality Disorders
• Personality disorders are patterns of inflexible traits that
disrupt social life or work and may distress the affected
individual.
• Four common personality disorders are paranoid,
schizoid, antisocial, and avoidant.
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Psychological Disorders
Personality Disorders
Main Idea
Personality disorders are characterized by patterns of unchanging
personality traits that disrupt people’s social lives and work lives.
Reading Focus
• What are personality disorders, and how do they differ from other
psychological disorders?
• What are ten types of personality disorders?
• How do psychological and biological views explain the origins of
antisocial personality disorder?
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Psychological Disorders
Why does Lisa
demand so much
attention?
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Psychological Disorders
What Are Personality Disorders?
• Personality disorders: patterns of inflexible traits that disrupt
social life or work and may distress the affected individual
• An enduring pattern of inner experience and behavior that
deviates markedly from the expectations of the culture of the
individual who exhibits it
• Usually show up by late adolescence
• Psychological disorders are illnesses that an individual
experiences as episodes. In contrast, personality disorders are
enduring traits that are major components of the individual’s
personality.
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Psychological Disorders
Reading Check
Contrast
How are personality disorders different from
other disorders that they may resemble?
Answer: Personality disorders are patterns of inflexible,
enduring traits, not episodes of illness.
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Psychological Disorders
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Psychological Disorders
Reading Check
Analyze
What are some ways that personality
disorders can make life difficult?
Answer: Individuals with personality disorders have great
difficulty making friends and developing lasting relationships with
others, and it is difficult for them to retain or achieve success in a
job, which can lead to further isolation or financial hardship.
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Psychological Disorders
Explaining Personality Disorders
Both psychological and biological theories have been
suggested to explain some of them.
Psychological Views
Biological Views
• Psychoanalytic theory suggests
a lack of guilt underlies the
antisocial personality.
• Antisocial personality disorder
appears to run in families.
• Learning theorists suggest
children who are not reinforced
for good behavior learn
antisocial behavior.
• Cognitive theorists argue
antisocial teens use a faulty
view of others’ actions.
• Some evidence suggests that
antisocial people have less
developed emotional centers in
their brains.
• Biological factor by itself is
unlikely to cause the
development of antisocial
personality disorder.
Original Content Copyright by HOLT McDougal. Additions and changes to the original content are the responsibility of the instructor.
Psychological Disorders
Original Content Copyright by HOLT McDougal. Additions and changes to the original content are the responsibility of the instructor.
Psychological Disorders
Reading Check
Analyze
How may childrearing affect the
development of antisocial personality
disorder?
Answer: If rejected, punished harshly, raised with a lack of
affection, or lack appropriate role models, children may develop
an antisocial personality disorder.
Original Content Copyright by HOLT McDougal. Additions and changes to the original content are the responsibility of the instructor.
Psychological Disorders
Lab: Applying What You’ve Learned
Diagnosing Psychological Disorders
Can you diagnose a psychological disorder based on a
written description of someone’s symptoms?
1. Introduction
2. Writing the Case Studies
• In this lab, you will work in
groups to review one of the six
types of disorders you have
learned about.
• Select two specific disorders
• Ensure your case study has
each of the pieces on the
sample case study illustrated.
• With your group, conduct
additional research to write a
fictional case study.
Original Content Copyright by HOLT McDougal. Additions and changes to the original content are the responsibility of the instructor.
Psychological Disorders
Original Content Copyright by HOLT McDougal. Additions and changes to the original content are the responsibility of the instructor.
Psychological Disorders
Lab (cont'd.)
3. Diagnosing the Disorders
4. Discussion
• Someone from each group
should share the main points
about the type of disorder
assigned to their group.
• As a class, discuss the
following:
• Listen to your teacher read
each case study aloud.
• Jot down your diagnosis.
• As a class, vote for which
psychological disorder was
described.
• How successful was the class
at diagnosing the psychological
disorders described?
• Were some disorders
particularly easy to diagnose?
Or particularly hard?
• How would this lab have been
different if some of the case
studies had described multiple
disorders?
Original Content Copyright by HOLT McDougal. Additions and changes to the original content are the responsibility of the instructor.
Psychological Disorders
Original Content Copyright by HOLT McDougal. Additions and changes to the original content are the responsibility of the instructor.