Psychology

Psychological
Disorders
4D ’
Deviant - different, extreme, unusual, bizarre behaviour
Distressing - behaviour that is unpleasant and upsetting to the person
and others

s
Dysfunctional - inability to carry out daily activities in a constructive
(functional) way
Dangerous - behaviour that is harmful to self and others

Approaches used to distinguish bet ween normal and

abnormal behaviour

First approach Second approach

- views abnormal behaviour as a deviation from - views abnormal behaviour as
social norms maladaptive
- abnormal behaviour→ deviant from social - Whether it fosters well being of
expectations individual/group he belongs to
- each society has norms - Well being includes growth and
- societies norms grow from its culture fulfilment → the actualization
-Behaviours, thoughts, and emotions that break (achieving) of potential
norms → abnormal - conforming behavior→ abnormal if it
-society's norms may change over time is maladaptive

the stigma attached to mental illness

• People have vague (unclear) ideas about psychological disorders that are characterised by
superstition, ignorance and fear.
• It is believed that mental illness is something to be ashamed of.
• The stigma attached to mental illness means that people are hesitant to consult a doctor or
psychologist because they are ashamed of their problems.
• Psychological disorders indicate a failure in adaptation and should be treated as any other illness.
 Historical background
1. One ancient theory
6. The Middle Ages
Abnormal behaviour can be explained by the operation of
demonology and superstition gained importance.
supernatural and magical /forces such as evil spirits
(bhoot-pret) or the devil (shaitan). There were instances of witch hunt.
• Exorcism - removing evil spirits that resides in the • St. Augustine wrote about feelings, mental
individual through counter magic and prayer is common. anguish and conflict - groundwork (foundation)
• The shaman, or medicine man (ojha) is a person who has for psychodynamic theories of abnormal
contact with supernatural forces. behaviour.
• The shaman can communicate with an afflicted person
(someone with mental illness) and appease (please) the 7. Renaissance Period
spirits. Johann Weyer said that psychological conflict
and disturbed interpersonal relationships are the
2. Biological or Organic Approach cause of psychological disorders.
Individuals behave strangely because their bodies and • He said that witches were mentally disturbed
brains are not working properly. and require medical, not theological (burning)
treatment.
3. Psychological Approach
Psychological problems are caused by inadequacies in the 8. 17" & 18" centuries
way an individual thinks, feels and perceives. Age of Reason and Enlightenment - scientific
methods used to explain and understand abnormal
4. Organismic Approach behaviour.
Hippocrates, Socrates and Plato - Organismic • Reform Movement - increased compassion for
Approach - disturbed behaviour arises out of conflicts people who suffered from disorders.
between emotion (feel) and reason (think). • Asylums were set up in Europe & America
• Deinstitutionalization - emphasis on providing
5. Galen community care for the recovered mentally ill (how to
Role of four humours in character and temperament - help them adjust back to normal life).
world is made up of four elements, .i.e. earth, air, fire
and water. 9. Interactional or bio-psycho-social
• These combine to form body fluids, i.e. blood, black approach
bile, yellow bile and phlegm. all three factors; biological, psychological and
• Imbalances among the humours (fluids) cause various social play an important role in the outcome of
disorders. disorders.
CLASSIFICATION OF PSYCHOLOGICAL
DISORDERS
1. DSM-5
• Published by The American Psychiatric Association (APA).
• The current version- Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
• Clinical criteria which indicates the presence or absence of disorders

2. ICD-10
• Officially used in India.
• Tenth revision of the International Classification of Diseases (ICD-10) which is known as the
ICD-10 Classification of Behavioural and Mental Disorders.
• Prepared by World Health Organization (WHO).
• For each disorder, a description of the main clinical features or symptoms and diagnostic
guidelines is provided in the scheme.

FACTORS UNDERLYING ABNORMAL BEHAVIOUR

(Causes of Abnormal Behaviour)
1. Biological Factors 2. Genetic Factors
• Potential causes of abnormal behaviour are faulty • Many genes combine to bring out behaviours and emotions:

genes, endocrine imbalances (related to the glands), functional and dysfunctional.

• Researchers have not been able to identify the specific genes
malnutrition. injuries, etc.
that cause abnormality.
• Psychological disorders are also related to
• Genetic factors are involved in schizophrenia, depression,
transmission of messages from one neuron to another.
anxiety, etc.
• When electric impulses reach a neuron ending, they
3. Psychological Factors
release a chemical called neurotransmitter.
• Factors such as maternal deprivation, separation from mother,
• Imbalance in neurotransmitters causes psychological
lack of warmth during early years, etc. can lead to psychological
disorders. disorders.
• Low activity of GABA (gamma amino butyric acid) Other factors include:
causes anxiety disorders. - Faulty parent child relationship (rejection, overprotection, faulty
• Excess activity of Dopamine causes schizophrenia. discipline)
• Low activity of Serotonin causes depression. - Maladaptive family structures (disturbed family environment)
- Stress
 Psychological Models are:
a) Psychodynamic Model
• Behaviour is determined by psychological forces within the person.
• These forces are dynamic.
• Conflicts between these forces - id, ego, and super ego can lead to abnormal behaviour.
• Abnormal behaviour is a result of unconscious mental conflict during childhood.
b) Behavioural Model
• Disorders are a result of learning maladaptive ways of behaving.
• Eg: A child abuses - not checked by parents - learns the behaviour of abusing.
• Behaviours can be learned and unlearned.
• Learning can take place by classical conditioning (stimulus- response association), operant
conditioning (reward punishment) and social learning (imitation and observation).
c) Cognitive Model
• Abnormal functioning is due to cognitive problems (related to mental processes).
• People can hold irrational and inaccurate thoughts and attitudes.
• They may think in illogical ways (no one loves me), make over generalizations (if one politician is corrupt, all will be corrupt) and draw negative
conclusions on the basis of one single event (I did not do well in one exam; I will do badly in all others also).
d) Humanistic - Existential Model
• Human beings are born with a natural tendency to be friendly, cooperative and constructive.
• They are driven towards self-actualization (reach fullest potential).
• We have the freedom to give meaning to our existence.
• Those who avoid this responsibility live empty and dysfunctional lives.

4. Socio - Cultural Model

• Socio-cultural factors such as war, violence, group prejudice, discrimination, economic and employment
problems, rapid social change - put stress and lead to psychological problems.
• Behaviour is shaped by societal forces - family, social network, societal conditions, societal labels and roles.
• Certain family systems produce abnormal functioning over involvement in each other's lives will make the
children less independent.
• People who are isolated and lack social support are likely to be depressed.
• When people break societal norms - they are called mentally ill.
• People accept these labels and start functioning in a disturbed manner.
5. Diathesis Stress Model
• Three components of this model are:
a) Diathesis or presence of a biological aberration which is inherited (gene).
b) Vulnerability to develop the disorder - person is "at risk' or predisposed (prone) to develop a psychological
disorder.
c) Presence of a stressor (stressful situations) that can lead to psychopathology (disorder).
• If "at risk' persons are exposed to stressors, the predisposition can turn into a psychological disorder.
 anxiety disorder
general points common symptoms
- most common psychological disorder worry, fear, apprehension,
- high levels of anxiety are distressing rapid heart rate, sweating,
- interference with effective functioning breathlessness, diarrhoea,
loss of appetite, fainting,
dizziness, sleeplessness,
tremors, frequent urination

types of anxiety disorder

generalised panic disorder phobias separation

anxiety disorder anxiety disorder
- recurrent anxiety
attack - fearful and
- prolonged, vague,
- intense terror specific anxious about
intense fear
- anxiety rising to peak phobia social agarophobia separation from
- worry,
around particular phobia - fear of attachment figures
apprehension stimulus - most unfamiliar
intense fear or - developmentally
- hyper vigilant - thoughts related to common situations
embarrassment not appropriate
- motor tension stimulus are - irrational - afraid of
when dealing - children with
- restless, tense, unpredictable fear with others leaving homes
SAD: suicidal
shaky - symptoms: breathless, - towards - ability to
gestures, fuss,
- no particular dizziness, trembling, animal, closed carry normal
scream, severe
cause/ fear palpitations, chocking, life activity is
place etc tantrums
nausea, chest pain, limited
discomfort, fear of
going crazy, losing
control, fear of dying
 obsessive compulsive
and related disorders
- unable to control their preoccupation with specefic ideas
- unable to control themselves from carrying out certain acts
- obsession/ obsessive behaviour- inability to stop thinking
about particular idea/ thought. Thoughts are unpleasant and
shameful
- compulsion/ compulsive behaviour- need to perform certain
behaviours over and over again
- eg: counting, washing, checking, ordering, touching

trauma and stressor

related disorders (PTSD)
general points: symptoms:
- victims of natural disaster, bomb blasts, wars, - recurrent dreams
accidents etc. - flashbacks
- adjustment disorder and acute stress disorder - impaired concentration
are also included in this category - emotional numbing
somatoform disorders
3 types

somatic symptom illness anxiety

disorder disorder
- anxiety is main concern
- physical complaints
both are - preoccupation about
- persistent body related
concerned developing a serious
symptoms
- overly pre occupied with medical illness
with symptoms illness - concerned about
- continually worry undiagnosed disease
about health - don’t respond to
- frequents doctor visits assurance by doctors
- significant distress and - easily alarmed about
disturbance in daily life illness

conversion
disorder
- loss of part or all of some symptoms:
basic body functions paralysis
- occur after stressful blindness
experiences deafness
- may be quite sudden difficulty in walking
 dissociative
d i s s o c i a t i v e disorders
d i s o r d e r s

Types:
- severance of connections between ideas and emotions
- feelings of unreality, enstrangement, depersonalisations,
dissociative
loss or shift of identity dissociative depersonalisation/
amnesia derealisation
- sudden temporary alternations of consciousness that blot identity
disorder
out painfull experiences disorder

dissociative identity
disorder

- multiple personality disorder

- most dramatic
- associated with traumatic childhood experiences
- person assumes alternate personalities that may
or may not be aware of each other
depersonalisation/
derealisation disorder dissociative
amnesia
- dream like state - selective memory loss
- no organic cause or physical injury
- sense of being separated from - cannot remember anything about their past
self and reality - no longer recall specific events, people, places, objects,
while memory for other events remains intact
- change of self perception
- dissociative fatigue
- reality is temporarily lost or - unexpected travel away from home or workplace

changed - assume new identity: can’t recall previous one

- fugue ends when person wakes up with no memory of
events that occurred during fugue
- overwhelming stress
depressive disorders

major depressive disorders are defined as:

causes: - period of depressed mood

- loss of interest
- genetic makeup (heredity)
- change in body weight
- age
- constant sleep problems
- women: young adulthood ; men: early
- tiredness
middle age - inability to think clearly
- gender - agitation
- women are more prone than men - restlessness
- negative life events - slowed behaviour
- lack of social support - thoughts of death and suicide
- excessive guilt
- feeling of worthlessness

- most widely prevalent and recognised of all

mental disorders
- negative moods and behavioural changes
- depression can be a symptom or disorder
- depression: normal feeling after significant loss
 bipolar and related disorders
Bipolar I Cyclothymic disorder
- depression
- periods of normal mood
Bipolar 2
-mania
Strengthening students
self esteem:
Suicide - accentuate positive life experiences
- development of physical, social and
-biological, genetic, psychological, sociological, vocational skills
cultural, environmental factors - trustful communication
- risk factor —> mental illness, violence abuse,
- goals for students should be
reflect, previous attempt
specific, measurable, achievable,
Problem solving

- difficulties relevant, completed within relevant

Emotional expression
time frame
Stess management '

- devastating and long lasting effects

- a lot of stigma around suicide
- identification, referral, management of
behaviour -> crucial to prevent suicide Identifying students
- identity vulnerability, comprehend the in distress
circumstances
- suicide is preventable
Unexpected or striking change affecting
- measures suggested by WHO:
- limiting access to means of suicide
the adolescents performance,
- reporting suicide in a responsible way (by media) attendance, or behaviour should be taken
- alcohol related politics
seriously, such as:
- identification, treatment, care of people at risk
- training health workers - lack of interest
- care for people
- declining grades
- community support
- decreasing effort
- misbehaviour in class
- mysterious/repeated absence
- smoking, drinking or drug misuse
 Schizophrenia
Symptoms

Negative symptoms Psychomotor symptoms

Positive symptoms
-Pathological excesses -Pathological deficits - bizarre postures and facial expressions
- treated with medication - treaded with therapy -Catatonia
Types
Delusion of persecution
Types Types

Alogia Catatonic stupor

Delusion of reference
Delusions
Delusion of grandeur Poverty/reduction of Remain motionless and silent for

speech and speech content long stretches of time

Delusion of control

Catatonic rigidity
Loosening of association/
derailment
Blunted affect Maintain rigid, upright postures
Less anger, sadness, joy for hours
Formal thought
and other feelings
Neologisms
disorder Catatonic posturing
Perseveration
Assume awkward, bizarre positions
Auditory Flat affect for long periods of time
No emotions at all
Tactile

Hallucinations Somatic Abolition or apathy

Inability to start or complete a
Visual
course of action or goal
Gustatory

Olfactory

Inappropriate affect

General points

- Psychotic
- social, personal, occupational deterioration
- disturbed thought, perception, emotions,
motor abnormalities
- debilitating
neurodevelopemental disorders
- inattention
- hard time keeping their mind on one thing
- can’t concentrate, not follow instructions, disorganised, easily distracted, forgetful,
ADHD-
attention don’t complete assignments, quick to loose interest
deficit - impulsivity
hyperactivity
disorder - difficult to wait , take turns
- minor mishaps
- hyperactivity
- fidget, squirm, climb, run
- driven by a motor, always on the go, talk incessantly

- impairments in social interaction and communication

- stereotyped patterns of behaviour, interest and activities
- restricted range of interests
- desire for routine
- 70% of children with autism spectrum have intellectual disabilities
Autism - unable to initiate social behaviour
spectrum - unresponsive to others feelings
disorder
- unable to share experiences/ emotions
- abnormalities in language and communication
- many-> never develop speech ; those who do-> repetitive and deviant patterns
- narrow interests
- repetitive behaviours (lining up objects)
- self stimulatory (hand flapping), self injurious (banging head against wall) movement
 - below average intellectual functioning
Intellectual
disability - deficits in adaptive behaviour
- before 18 yrs

Specific - Difficulty in perceiving and processing information

Learning - problems → basic reading, writing and mathematics
Disorder - child → perform below average
- can do well with additional efforts and inputs
 Disruptive, impulsive-control, and conduct
disorders

Oppositional Defiant Disorder (ODD)

- age inappropriate amount of stubbornness
- irritable, defiant, disobedient, hostile
- reaction to a circumstance
- problematic interactions

Conduct Disorder and Anti Social Behaviour

- age inappropriate actions
- attitude that violates family expectations, societal norms and personal or property rights
of others
- aggressive actions
- cause/ threaten harm to people or animals
- deceitfulness or theft
- violation of rules
- 4 types of aggression

Verbal
aggression Proactive
Physical Hostile
aggression aggression
aggression
Feeding and eating disorders

Anorexia nervosa
- distorted body image
- view yourself as overweight
- refuse to eat
- exercising compulsively
- unusual habits → refuse to eat in front of others,
lose large amount of weight, may starve him/herself
to death

Bulimia nervosa
- eat excessive amount of food and then purge by using
medicines such as laxatives or diuretics or by vomiting
- feels ashamed of binging and releases negative
emotions and tension after purging

Binge eating
- out of control eating
- eat at a higher speed than normal
- eat till uncontrollably full
- eat large amounts even when not hungry
 Substance related and addictive
disorders
Substance
Definition- maladaptine behaviors resulting
Dependence Abuse
from regular and consistent use of the - intense craving - consequences

substance involved are called substance abuse - tolerance and - damage their family and social relationships,
perform poorly at work, create physical hazards
withdrawal
disorders

Heroin abuse and dependence

- interferes with social and occupational functioning
- tolerance and withdrawal
- overdose → slow down respiratory centre of the
brain, almost paralysing breathing → causing death
Cocaine abuse and dependence
- Regular use → keeps person intoxicated
throughout the day
-Function poorly in social relationships and at
work
- problems in short term memory and attention
- tolerance and withdrawal

Alcohol abuse and dependence

- People→ drink large amounts regularly.→ rely on it to help them face difficult
situations
-Drinking interferes with social behaviour and ability to think and work
- Tolerance and withdrawal
- Destroys families, social relationships and careers
- Intoxicated driver → road accidents
- children of addicts → psychological problems, anxiety, depression, phobias,
substance related disorders
- excessive drinking → damage physical health