Chapter Eleven
Psychological
Disorders
Did You Know That…
• Behavior considered abnormal in one
culture may be deemed perfectly normal in
another?
• Psychological disorders affect nearly
everyone in one way or another?
• Some people have such fear of leaving the
house that they literally are unable to go
out to buy a quart of milk?
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11-2
Did You Know That… (Cont’d)
• Some people have lost all feeling in an
arm or leg but remain unconcerned about
their ailments?
• Some health professionals use bright light
to treat depression – and it works?
• Some people with schizophrenia sit
motionless for hours as though they were
statues?
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11-3
Did You Know That… (Cont’d)
• People who receive the label of
psychopath are not psychotic?
• Despite popular beliefs to the contrary,
people who threaten suicide are quite
likely serious about taking their lives?
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11-4
Module 11.1
What Is Abnormal Behavior?
Module 11.1 Preview Questions
• What criteria are used to determine
whether behavior is abnormal?
• What are the major models of abnormal
behavior?
• What are psychological disorders?
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11-6
Criteria Typically Used to Identify Abnormal
Behavior
•
•
•
•
•
•
Unusualness
Social deviance
Emotional distress
Maladaptive behavior
Dangerousness
Faulty perceptions or interpretations of
reality
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11-7
Cultural Bases of Abnormal Behavior
• Cultural context important when making
judgments about abnormal behavior
• Abnormal behavior patterns may be
expressed differently in different cultures.
• Judgments of what is abnormal behavior
can change over time.
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11-8
Early Beliefs About Abnormal Behavior
• Abnormal behaviors caused by
supernatural forces
• Doctrine of demonic possession
• Treatment was exorcism
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Medical Model of Abnormal Behavior
• Result of the rapid advances in medical
science during 18th and 19th centuries
• Abnormal behavior patterns represent
mental illnesses that have a biological
basis.
• Can be classified by their particular
characteristics or symptoms
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Psychological Models of Abnormal Behavior
• Psychodynamic Model: Abnormal
behaviors arise from unconscious
conflicts.
• Psychological symptoms are the outward
expressions of inner turmoil.
• Behavioral Model: Abnormal behaviors are
learned.
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11-11
Psychological Models of Abnormal Behavior
(Cont’d)
• Humanistic Model: Abnormal behaviors
result from roadblocks on the path toward
self-actualization.
• Cognitive Model: Irrational or distorted
thinking leads to emotional problems and
maladaptive behaviors.
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Sociocultural Model of Abnormal Behavior
• Views causes of abnormal behavior within
a broader social and cultural context
• Abnormal behavior may have more to do with
social ills or failures of society.
• Focus also on the effects of labeling
people as mentally ill
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Biopsychosocial Model of
Abnormal Behavior
• Abnormal behavior results from the
complex interactions of biological,
psychological, and sociocultural factors.
• Example: Diathesis-Stress Model
• Diathesis: What is the person’s vulnerability or
predisposition to developing a disorder?
• Stress: What level of stress is the person
experiencing?
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Figure 11.1: The Diathesis-Stress Model
From Abnormal Psychology in a Changing World 4/e by Nevid/Rathus/Greene, pp.35-36 Reprinted by adaption of Prentice-Hall Inc, Upper Saddle River, NJ.
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Psychological Disorders
• Distinctive patterns of abnormal behavior
• Also known as “mental disorders” or “mental
illnesses”
• Involve disturbances of mood, behavior,
thought processes, or perceptions that
result in significant personal distress or
impaired functioning
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Classification of Psychological Disorders
• Diagnostic and Statistical Manual of Mental
Disorders (DSM) now in a 4th, text revised
edition (DSM-IV-TR).
• Multiaxial system
•
•
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Axis I: Clinical disorders
Axis II: Personality disorders
Axis III: General medical conditions
Axis IV: Psychosocial and environmental problems
Axis V: Global assessment of functioning
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Module 11.2
Anxiety Disorders
Module 13.2 Preview Questions
• What are anxiety disorders?
• What causal factors are implicated in
anxiety disorders?
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What is an Anxiety Disorder?
• Anxiety can be an adaptive response.
• But can become abnormal when excessive or
when interferes with ability to function
• “Fear” is used to describe anxiety
experienced in specific situations.
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Phobias
• An irrational or excessive fear of some
object or situation
• Three types of phobic disorders:
• Social Phobia
• Specific Phobia
• Agoraphobia
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Panic Disorder
• Person experiences sudden episodes of
sheer terror called panic attacks.
• Panic attacks are characterized by intense
physical symptoms.
• Over time, panic attacks can become
associated with specific situations.
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Generalized Anxiety Disorder
• Persistent anxiety not tied to any particular
object or situation
• Anxiety has a “free-floating” quality
• Key feature is excessive worry
• Other characteristics include shakiness,
inability to relax, fidgeting, and feelings of
dread and foreboding.
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Obsessive-Compulsive Disorder
• Person experiences persistent obsessions
and/or compulsions
• Obsessions: Nagging, intrusive thoughts
person feels unable to control
• Compulsions: Repetitive behaviors or rituals
the person feels compelled to perform
repeatedly
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11-24
Causes of Anxiety Disorders
• Biological factors:
• Heredity
• Disturbances in brain biochemistry or circuits
• Psychological factors:
• Classical conditioning
• Operant conditioning
• Cognitive factors
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11-25
Figure 11.2: Cognitive Model of Panic
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11-26
Module 11.3
Dissociative and Somatoform Disorders
Module 11.3 Preview Questions
• What are dissociative disorders and
somatoform disorders?
• What causal factors are implicated in
dissociative and somatoform disorders?
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11-28
Dissociative Disorders
• Involve problems with memory or changes
in consciousness or self-identity
• Inability to maintain a cohesive sense of
self or unity of consciousness
• Results in unusual or bizarre behavior
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Dissociative Identity Disorder
• Dissociative Identity Disorder (DID): Two
or more distinct personalities exist within
same individual
• Commonly called “multiple” or “split
personality”
• Women tend to have 15+ identities; men
tend to have 8+ identities.
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Dissociative Amnesia
• Loss of memory about self or life
experiences
• No physical cause for amnesia
• Memory lost usually involves a stressful or
traumatic event.
• Generalized amnesia is much less common.
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11-31
Causes of Dissociative Disorders
• Role of traumatic experiences:
• Childhood sexual abuse
• Psychological pain or conflict
• Is DID a genuine disorder?
• A form of attention-seeking role playing?
• Inadvertently cued by therapists?
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11-32
Somatoform Disorders
• Person has physical ailments or
complaints that cannot be explained
medically
• Or may have belief that gravely ill despite
reassurances to the contrary
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11-33
Conversion Disorder
• Loss of functioning, feeling, or movement in
specific body part
• But no physical cause for the symptoms.
• Lack of concern with symptoms
• La belle indifférence
• May be a way of avoiding anxiety associated
with painful or stressful conflicts or situations
• Many cases turn out to be unrecognized medical
conditions.
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Hypochondriasis
• Preoccupied with idea of health problems
• Attribute physical complaints or symptoms to
a serious underlying disease
• Rejects reassurances that concerns are
groundless
• May not realize how their anxiety may be
causing the symptoms being experienced
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11-35
Causes of Somatoform Disorders
• Freud: Hysterical symptom an indication of
unconscious conflicts
• Learning Theories: Symptoms help person
avoid painful or anxiety-evoking situations
• Reinforcement for “sick role”
• Cognitive Theories: Cognitive biases lead
to misinterpreting bodily symptoms.
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11-36
Module 11.4
Mood Disorders
Module 13.4 Preview Questions
• What are mood disorders?
• What causal factors are implicated in
mood disorders?
• Who is at risk for suicide?
• Why do people commit suicide?
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11-38
Mood Disorders
• Severe or persistent disturbances of mood
that limit one’s ability to function
• Will focus on two major forms of mood
disorder:
• Major Depressive Disorder
• Bipolar Disorder
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Major Depressive Disorder
• Symptoms:
•
•
•
•
•
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Depressed mood for at least two weeks
Sadness
Worthlessness
Changes in sleep, appetite
Lethargy
Loss of interest, concentration
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11-40
Prevalence of Major Depression
• About 16% of adult U.S. population develop
major depression at some point.
• Women twice as likely as men to develop
disorder
• Possibly due to hormonal or other biological
differences one possible explanation
• But also may be due to differences in levels of stress
experienced
• Gender differences in how one copes with
depression
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Bipolar Disorder
• Person shifts between manic episodes
and periods of depression with intervening
periods of normal mood
• Formerly called manic-depression
• About 1% of adult U.S. population suffers
from a bipolar disorder.
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11-42
Psychological Models of Depression
• Classic Psychodynamic Theory: Depression
involves anger turned inward against self.
• Behavioral Model: Depression results from
changes in reinforcement levels.
• Cognitive Model: How people interpret events
contributes to emotional disorders.
• Aaron Beck: One is prone depression if adopt a
negatively biased or distorted way of thinking.
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11-43
Cognitive Distortions Linked to Depression
(see Table 11.2 for more detail)
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All-or-nothing thinking
Misplaced blame
Misfortune telling
Negative focusing
Dismissing the
positive
• Jumping to
conclusions
• Catastrophizing
• Emotion-based
reasoning
• Shouldisms
• Name calling
• Mistaken
responsibility
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11-44
Learned Helplessness Model
• Depression results from belief that one is
helpless to control reinforcements.
• Reformulated Model: How are negative
events explained?
• Depressive Attributional Style involves making
internal, global, and stable attributions for
disappointments and failures.
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Causes of Mood Disorders:
Biological Factors
• Chemical imbalances in brain involving the
levels or activity of neurotransmitters
• Hereditary influences
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Suicide
• Nearly one-half million Americans make serious
suicide attempts each year.
• About 30,000 Americans and 1 million people
worldwide commit suicide each year.
• Third leading cause of death among 15-24 year
olds.
• About 10% of college students seriously thought
of committing suicide during preceding year.
• Nearly 1 in 20 adult Americans reported making
a prior suicidal attempt.
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Figure 11.3: Suicide Rates in
Relation to Age
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Figure 11.4: Suicide Rates in Relation to
Gender and Ethnicity
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Factors in Suicide
• Closely linked to mood disorders
• Role of biochemical factors?
• Lack of serotonin may lead to a disinhibition
effect
• Drugs and alcohol
• Lack of coping responses
• Exit events or losses of supportive
persons
• Teens and copycat suicides
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11-50
Myths About Suicide
(see Table 11.3 for more detail)
• People who threaten suicide are only seeking
attention.
• A person must be insane to attempt suicide.
• Talking about suicide with a depressed person
may prompt the person to attempt it.
• People who attempt suicide and fail aren’t
serious about killing themselves.
• If someone threatens suicide, it is best to ignore
it so as not to encourage repeated threats.
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11-51
Module 11.5
Schizophrenia
Module 11.5 Preview Questions
• What is schizophrenia?
• What are the three specific types of
schizophrenia?
• What causal factors are implicated in
schizophrenia?
• What is the diathesis-stress model of
schizophrenia?
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11-53
Schizophrenia
• Most closely corresponds to popular notion of
insanity or madness
• Affects about one adult in a hundred
• Characterized by bizarre, irrational behavior
• Somewhat more common in men than in
women
• Follows a lifelong course
• Typically develops in late adolescence or early
adulthood
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Symptoms of Schizophrenia
• A psychotic disorder:
• Confuses fantasy with reality
• Experiences hallucinations and delusions
• May exhibit bizarre behavior, incoherent
speech, and illogical thinking
• Positive vs. negative symptoms
• Behavioral excesses vs. behavioral deficits
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Types of Schizophrenia
• Disorganized
• Catatonic
• Paranoid
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Causes of Schizophrenia
•
•
•
•
Genetic factors
Biochemical imbalances
Brain abnormalities
Psychosocial influences
• Stressful life experiences
• Diathesis-stress model revisited
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11-57
Figure 2.20: Familial Risk in Schizophrenia
Return
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Module 11.6
Personality Disorders
Module 11.6 Preview Questions
• What are personality disorders?
• What characteristics are associated with
antisocial personality disorder?
• What causal factors are implicated in
antisocial personality disorder?
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11-60
Personality Disorders
• A cluster of psychological disorders
characterized by excessively rigid patterns
of behavior
• Behavioral patterns become self-defeating.
• Person has deeply ingrained maladaptive
personality traits
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Types of Personality Disorders
•
•
•
•
•
Paranoid
Schizoid
Schizotypal
Antisocial
Borderline
•
•
•
•
•
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Histrionic
Narcissistic
Avoidant
Dependent
Obsessivecompulsive
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Symptoms of Antisocial Personality Disorder
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Disregard for rules
Lack of concern for others
Act on selfish impulse
Irresponsible
Take advantage of others for own need or
personal gain.
• Lack remorse for mistreatment of others
• May be highly intelligent and charming
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Causes of Antisocial Personality Disorder
• Brain abnormalities
• Genetic contributions
• Exaggerated cravings for stimulation
• Environmental factors
• Family history
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Application: Module 11.7
Suicide Prevention
Module 11.7 Preview Question
• What steps can you take to help someone
who is threatening suicide?
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Facing the Threat of Suicide
• Recognize the seriousness of the
situation.
• Take implied threats seriously.
• Express understanding.
• Focus on alternatives.
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Facing the Threat of Suicide (Cont’d)
• Assess the immediate danger.
• Enlist the person’s agreement to seek
help.
• Accompany the person to seek help.
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11-68