9.

Psychological Disorders
Psychological Disorders

A “harmful dysfunction” in which behavior is judged to be:

• atypical- not enough in itself

• disturbing- varies with time & culture

• maladaptive- harmful

• unjustifiable- sometimes there’s a good reason

Historical Perspective
• Perceived Causes

• movements of sun or moon

• lunacy- full moon

• evil spirits

• Ancient Treatments

• exorcism, trephination, caged like animals, beaten, burned,

castrated, mutilated, blood replaced with animal’s blood

Psychological Disorders

• Medical Model

• concept that diseases have physical causes

• can be diagnosed, treated, and in most cases, cured

• assumes that these “mental” illnesses can be diagnosed on the

basis of their symptoms and cured through therapy, which may
include treatment in a psychiatric hospital

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 • Bio-psycho-social Perspective

• assumes that biological, sociocultural, and psychological factors

combine and interact to produce psychological disorders

Psychological Disorders- Etiology

• DSM-5

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 • American Psychiatric Association’s Diagnostic and Statistical
Manual of Mental Disorders (FifthEdition)

• a widely used system for classifying psychological disorders

• Neurotic disorder (term seldom used now)

• usually distressing but that allows one to think rationally and

function socially

• Freud saw the neurotic disorders as ways of dealing with anxiety

A.Psychotic disorder
• person loses contact with reality

• experiences irrational ideas and distorted perceptions

B.Anxiety Disorders
• Anxiety Disorders

• distressing, persistent anxiety or maladaptive behaviors that

reduce anxiety

• Generalized Anxiety Disorder (GAD)

• person is tense, apprehensive, and in a state of autonomic

nervous system arousal

• Phobia

• persistent, irrational fear of a specific object or situation

• Obsessive-Compulsive Disorder

• characterized by unwanted repetitive thoughts (obsessions)

and/or actions (compulsions)

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 • Panic Disorder

• marked by a minutes-long episode of intense dread in which a

person experiences terror and accompanying chest pain,
choking, or other frightening sensation

Common Obsessions and Compulsions Among People With

Obsessive-Compulsive Disorder

Thought or Behavior

Obsessions (repetitive thoughts)

Concern with dirt, germs, or toxins

Something terrible happening (fire, death, illness)

Symmetry order, or exactness

Compulsions (repetitive behaviors)

Excessive hand washing, bathing, tooth brushing,

or grooming

Repeating rituals (in/out of a door,

up/down from a chair)
Checking doors, locks, appliances,
car brake, homework

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 C.Mood Disorders
• Mood Disorders

• characterized by emotional extremes

• Major Depressive Disorder

• a mood disorder in which a person, for no apparent reason,

experiences two or more weeks of depressed moods, feelings of
worthlessness, and diminished interest or pleasure in most
activities

• Manic Episode

• a mood disorder marked by a hyperactive, wildly optimistic state

• Bipolar Disorder

• a mood disorder in which the person alternates between the

hopelessness and lethargy of depression and the overexcited
state of mania

• formerly called manic-depressive disorder

Mood Disorders-Depression

• Altering any one component of the chemistry-cognition-mood circuit

can alter the others

• A happy or depressed mood strongly influences people’s ratings of

their own behavior

Brain
Cognition
chemistry

Mood 57
Mood Disorders-Depression

• The vicious cycle of depression can be broken at any point

1
Stressful
experiences

4 2
Cognitive and Negative
behavioral changes explanatory style

3
Depressed
mood

D.Dissociative Disorders
• Dissociative Disorders

• conscious awareness becomes separated (dissociated) from

previous memories, thoughts, and feelings

• Dissociative Identity Disorder

• rare dissociative disorder in which a person exhibits two or more

distinct and alternating personalities

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 • formerly called multiple personality disorder

Schizophrenia
• Schizophrenia

• literal translation “split mind”

• a group of severe disorders characterized by:

• disorganized and delusional thinking

• disturbed perceptions

• inappropriate emotions and actions

• Delusions

• false beliefs, often of persecution or grandeur, that may

accompany psychotic disorders

• Hallucinations

• false sensory experiences such as seeing something without any

external visual stimulus

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Subtypes of Schizophrenia

Paranoid: Preoccupation with delusions or hallucinations

Disorganized: Disorganized speech or behavior, or

flat or inappropriate emotion

Catatonic: Immobility (or excessive, purposeless

movement), extreme negativism, and/or parrot-like
repeating of another’s speech or movements

Undifferentiated or residual: Schizophrenia symptoms without fitting one

of the above types

E. Personality Disorders
• disorders characterized by inflexible and enduring behavior
patterns that impair social functioning

• usually without anxiety, depression, or delusions

• Antisocial Personality Disorder (ASPD)

• disorder in which the person (usually man) exhibits a lack of

conscience for wrongdoing, even toward friends and family
members

• may be aggressive and ruthless or a clever con (fraud) artist

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 Childhood diagnoses of antisocials

• ADHD – (Attention Deficit Hyperactive Disorder) restless, inattentive,

don’t follow instructions or rules

• Conduct disorders – set fires, abuse animals and other children, low
attention span

• ODD- Oppositional defiant disorder – oppositional, stubborn,

negativistic, disobedient

3 Types of Antisocial Character Structure

i. Amoral Personalities

Amoral extroverts (narcissistic)

Amoral introverts (schizoid)

ii. Antisocial Impulse Disorders

iii. Sadistic Antisocials (heartless, brutal)

Epidemiology (causes)
• 3 percent in men and 1 percent in women

• Most common in poor urban areas and among mobile residents of

these areas

• Boys with the disorder come from larger families than girls with the
disorder

• The onset of the disorder is before the age of 15

• Girls usually have symptoms before puberty, and boys even earlier

• A familial pattern is present

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F. Borderline Personality Disorder
• Stand on the border between neurosis and psychosis and they are
characterized by extraordinarily unstable affect, mood, behavior,
object relations, and self-image

• No definitive prevalence studies are available, but borderline

personality disorder is thought to be present in about 1 to 2 percent of
the population and is twice as common in women as in men.

• recurrent suicidal behavior, gestures, or threats, or self-mutilating

behavior

• affective instability due to a marked reactivity of mood (e.g., intense

episodic irritability, or anxiety usually lasting a few hours and only
hours and only rarely more than a few days)

• chronic feelings of emptiness

• inappropriate, intense anger or difficulty controlling anger (e.g.,

frequent displays of temper, constant anger, recurrent physical fights)

• transient, stress-related paranoid ideation or severe dissociative

symptoms

Diagnosis

• Some patients with borderline personality disorder show shortened

REM latency and sleep continuity disturbances. Those changes,
however, are also seen in some patients with depressive disorders.

• Functionally, patients with borderline personality disorder distort their

relationships by considering each person to be either all good or all
bad. They see persons as either nurturing attachment figures or as
hateful, sadistic figures who deprive them of security needs and
threaten them with abandonment (neglect, rejection) whenever they
feel dependent. As a result of this splitting, the good person is

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 idealized, and the bad person devalued. Shifts of faithfulness from one
person or group to another are frequent.

Course and Prognosis

• Borderline personality disorder is fairly stable; patients change little
over time

• They have a high incidence of major depressive disorder episodes

• Diagnosis is usually made before the age of 40, when patients are
attempting to make occupational, marital, and other choices and are
unable to deal with the normal stages of the life cycle

The Psychopathic Personality

Psychopathic Personality: a person suffering from chronic mental disorder
with abnormal or violent social behaviour

• Sexual deviation

• Alcoholism

• Drug addiction

• They need relationships, but see people as obstacles to overcome and

be eliminated. If not, they see people in terms of how they can be
used. A psychopath can have high verbal intelligence, but they typically
lack "emotional intelligence

Sociopath

• Person having antisocial personality disorder

• Physical aggression

• Disregard for others

• Inability to keep a job or form relationships

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 • Violates the rights of others

• Lack of regret for inappropriate actions

Sociopath vs Psychopath
• Psychopaths are

• More organized in crimes

• Less easily recognized – appear “normal”

• More cunning

• Sociopaths are

• More agitated/nervous

• Act more spontaneously

• More socially inadequate – don’t fit in

All psychopaths have antisocial personality disorder, but not all

patients with ASPD are psychopaths

G. Conduct Disorder
• The childhood equivalent of antisocial personality disorder

• Characterized by Aggression to people/animals; Destruction of

property; Deceitfulness, lying, stealing; Serious violation of rules

• Diathesis-Stress: A more quasi-medical approach to criminal

psychology than is social learning theory. It assumes that criminal
behavior results from a “disorder” which is internal to the individual

• diathesis: Biological or personality predisposition

• stress: life events

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• Thus crime (or any disorder) results from an interaction of a
predisposition for that disorder with life stress in the absence of coping
skills.

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