PSYCHOLOGICAL

DISORDERS
CHAPTER-4
 CONCEPTS OF ABNORMALITY AND
PSYCHOLOGICAL DISORDERS:

DEVIANCE DISSTRESS DYSFUNCTION DANGER

DIFFERENT, UNPLEASANT AND INTERFERING WITH THE

FOR THE
EXTREME, UPSETTING TO THE PERSON’S ABILITY TO CARRY
PERSON OR
UNUSUAL, EVEN PERSON AND TO OUT DAILY ACTIVITIES IN A
OTHERS CONSTRUCTIVE WAY OTHERS
BIZARRE.
 APPROACHES:
1. DEVAITION FROM SOCIAL NORMS :
◦ Many psychologists have stated that ‘abnormal’ is simply a label that is given to a behaviour which is
deviant from social expectations.
◦ Each society has norms, which are stated or unstated rules for proper conduct. Behaviors, thoughts and
emotions that break societal norms are called abnormal. A society’s norms grow from its particular culture
— its history, values, institutions, habits, skills, technology, and arts.

2. MALADAPTIVE
When the behavior cannot be modified according to the needs of the situation, it is said to be
maladaptive.
Many psychologists believe that the best criterion for determining the normality of behaviour is not whether
society accepts it but whether it fosters the well-being of the individual and eventually of the group to
which s/he belongs.
 Reform movement:
Renaissance Period: interpersonal
Supernatural and
interpersonal relationships as causes
magical forces of psychological
relationships
disorders

Middle Ages,
Biological: Bodies and Interactional, or
demonology and
brains are not working biopsycho-social
superstition gained
properly approach
renewed importance

Organismic
HISTORICAL
Psychological
approach
approach: four
humours BACKGROUND
 HISTORICAL BACKGROUND:
◦ Supernatural and magical forces (removing the evil that resides in the individual through counter
magic and prayer; shamen and ohjas)
◦ Biological or organic approach (individuals behave strangely because their bodies and their brains are
not working properly)
◦ Psychological approach (inadequacies in the way an individual thinks, feels, or perceives the world)
◦ Organismic approach (Hippocrates, Socrates, and in particular Plato viewed disturbed behaviour as
arising out of conflicts between emotion and reason. Galen elaborated on the role of the four humours in
personal character and temperament. According to him, Imbalances among the humours (four essential
body fluids, viz. blood, black bile, yellow bile, and phlegm) were believed to cause various disorders.
Each of these fluids was seen to be responsible for a different temperament.)
◦ Middle Ages, demonology and superstition gained renewed importance (Demonology related to a
belief that people with mental problems were evil and there are numerous instances of ‘witch-hunts’
during this period.)
◦ Renaissance Period was marked by increased humanism and
curiosity about behavior (interpersonal relationships as causes of
psychological disorders)
◦ Age of Reason and Enlightenment, Reform movement
◦ Interactional, or biopsycho-social approach (all three factors, i.e.
biological, psychological and social play important roles in
influencing the expression and outcome of psychological disorders
CLASSIFICATION OF PSYCHOLOGICAL
DISORDERS

World Health
Organisation
(WHO),
International
Classification of
Diseases (ICD-
10)

The American Psychiatric Association (APA) :

Diagnostic and Statistical Manual of
Mental Disorders, 5 th Edition (DSM-5)
 FACTORS UNDERLYING
ABNORMAL BEHAVIOUR:
1. BIOLOGICAL FACTOR:
▪ Faulty genes, endocrine imbalances, malnutrition, injuries and other conditions may interfere with
normal development and functioning of the human body. (These factors are potential causes of abnormal
beh.)
▪ Psychological disorders are often related to problems in the transmission of messages from one neuron to
another (neuro-transmitter)
▪ Few examples:
➢Anxiety disorders (low activity of the neurotransmitter gamma
aminobutyric acid
(GABA))
➢Schizophrenia (excess activity of dopamine)
➢Depression to low activity of serotonin

2. GENETIC FACTORS:
◦ Genetic factors have been linked to bipolar and related disorders, schizophrenia, intellectual disability
and other psychological disorders.
3. psychological and interpersonal factors :
These factors include:
▪Maternal deprivation (separation from the mother, or lack of warmth and
stimulation during early years of life)
▪Faulty parent-child relationships (rejection, overprotection, over-
permissiveness, faulty discipline, etc.),
▪Maladaptive family structures (inadequate or disturbed family)
▪Severe stress

Moreover psychological models include the psychodynamic, behavioural,

cognitive, and humanistic-existential models.
PSYCHODYMAINC MODEL:

◦ This model was first formulated by Sigmund Freud who believed that three central forces shape
personality — instinctual needs, drives and impulses (id), rational thinking (ego), and moral
standards (superego).
◦ These internal forces are considered dynamic, i.e. they interact with one another and their
interaction gives shape to behaviour, thoughts and emotions. Abnormal symptoms are viewed as
the result of conflicts between these forces.

◦ So according to this approach abnormal behaviour is a symbolic expression of

unconscious mental conflicts that can be generally traced to early childhood
or infancy.
Behavioral model:
◦ Both normal and abnormal behaviours are learned and psychological disorders are the result of learning
maladaptive ways of behaving.

classical conditioning
(temporal association in
which two events
repeatedly occur close
together in time)
These three types of
conditioning account for
LEARNING operant conditioning behaviour, whether
TYPES (behaviour is followed by a adaptive or maladaptive.
reward)

social learning
(learning by imitating
others’ behaviour).
Cognitive model (result from cognitive problems)
◦ People may hold assumptions and attitudes about themselves that are irrational and inaccurate (IRRATIONAL
THOUGHTS)
◦ People may also repeatedly think in illogical ways and make overgeneralizations, that is, they may draw broad,
negative conclusions on the basis of a single insignificant event.

Humanistic-existential model which focuses on broader aspects of human

existence.
Existentialists believe that from birth we
Humanists are driven to self-actualize, i.e. to fulfil
have total freedom to give meaning to our
this potential for goodness and growth.
existence or to avoid that responsibility.

Those who avoid from this responsibility

would live empty, inauthentic, and dysfunctional lives.
This model believe that psychological distress arises
from feelings from lonliness, alienation, and an inability
to find meaning and genuine fulfillment in life.
◦ Socio-cultural factors

◦ Factors such as war and violence, group prejudice and

discrimination, economic and employment problems, and rapid
social change, put stress on most of us and can also lead to
psychological problems in some individuals.

◦ As behaviour is shaped by societal forces, factors such as family

structure and communication, social networks, societal
conditions, and societal labels and roles become more important.

◦ According to the sociocultural model, abnormal

behaviour is best understood in light of the social and
cultural forces that influence an individual.
Diathesis-stress model [important]

BIOLOGICAL + ENVIORNMENTAL FACTORS = PSYCHOLOGICAL DISORDERS/ABNORMAL BEH.

It states that psychological disorders develop when a diathesis (biological predisposition to

the disorder) is set off by a stressful situation.
◦ This model has three components.
1. The first is the diathesis or the presence of some biological aberration which may be
inherited.
2. The second component is that the diathesis may carry a vulnerability to develop a
psychological disorder. This means that the person is ‘at risk’ or ‘predisposed’ to develop
the disorder.
3. The third component is the presence of pathogenic stressors, i.e. factors/stressors that
may lead to psychopathology.
If such “at risk” persons are exposed to these stressors, their predisposition may actually
evolve into a disorder. This model has been applied to several disorders including anxiety,
depression, and schizophrenia.
PSYCHOLOGICAL
DISORDERS
◦ Anxious individual also shows combinations of the following symptoms:
➢rapid heart rate
➢shortness of breath
➢Diarrhoea
➢loss of appetite
➢Fainting
➢Dizziness
➢Sweating
➢Sleeplessness
➢Frequent urination and tremors.
WHAT IS THE DIFFERENCE BETWEEN
ANXIETY AND ANXIETY DISORDER ??
 ANXIETY
DISORDERS

GENERALISED SEPARATION
PANIC
ANXIETY PHOBIAS ANXIETY
DISORDER
DISORDER DISORDER

SPECIFIC
SOCIAL PHOBIA AGORAPHOBIA
PHOBIA
GENERALISED ANXIETY DISORDER:
◦ Prolonged, vague, unexplained and intense
fears that are not attached to any particular
object.
◦ The symptoms include:
➢Worry and apprehensive feelings about
the future
➢Hypervigilance - which involves
constantly scanning the environment for
dangers.
◦ It is marked by motor tension, as a result of
which the person is unable to relax, is restless,
and visibly shaky and tense.
 Everyday Responsibilities
Health-Related Thoughts •"Did I remember to lock the door? What if
someone breaks in?"
• "My child has a cough; what if it's something •"I need to do a perfect job cleaning the house,
serious?" or people will judge me."
• "I felt a pain in my chest; it must be a heart •"What if I forget something important and it
attack." causes a disaster?"
Financial Concerns
Social Situations
• "What if I lose my job and can't pay my bills?" •"What if I say something stupid and everyone
• "We don't have enough savings; what if an laughs at me?"
emergency happens?" •"I should have greeted them differently; now
they think I'm rude."
• "I'll never be able to retire comfortably; I'll end
up destitute. •"Everyone is looking at me and noticing how
nervous I am.“
Work or School Performance
• "If I don't get an A on this exam, I'll never get into General Worries
a good college." •"I can't relax; there's always something that
could go wrong."
• "Everyone at work thinks I'm incompetent."
•"What if I make a mistake and everyone finds
out?"
 PANIC DISORDER :
• It consists of repeated anxiety attacks in which the person experiences
intense terror.
• PANIC ATTACK: sudden episode of intense fear or discomfort that reaches a
peak within minutes and involves a variety of physical and cognitive symptoms.
• The clinical features/physiological symptoms include:

➢Shortness of breath
➢Dizziness
➢Trembling
➢fear of going crazy
➢losing control or dying.
➢chest pain or discomfort
➢Choking
➢Nausea
PHOBIAS: ◦ People who have phobias have irrational fears related
to specific objects, people, or situations.
◦ Phobias often develop gradually or begin with a
generalized anxiety disorder.
◦ Its three main types are:
1. Specific phobias: irrational fears such as intense
fear of a certain type of animal, or of being in an
enclosed space.
2. Social Phobias
3. Agoraphobia -- fear of entering unfamiliar
situations

Individuals with separation anxiety disorder are fearful

SEPARATION and anxious about separation from attachment figures to
ANXIETY DISORDER : an extent that is developmentally not appropriate.
IDENTIFY THE TYPE
OF ANXIETY
DISORDER:
https://youtu.be/jEkFp0Ux4OQ
https://youtu.be/L7u2v8PxXT4
◦ https://www.youtube.com/watch?v=n4gIMnU8E8U (GAD AND PANIC DISORDER)

◦ https://youtu.be/Ya1HfNY7898?si=UfQMGEf--LBp3ydt (PANIC DISORDER)

OCD and Related Disorders:
Individuals are unable to control their preoccupation with specific ideas
or are unable to prevent themselves from repeatedly carrying out a
particular act or series of acts that affect their ability to carry out normal
activities.

Obsessive behaviour Compulsive behaviour

Inability to stop thinking about a particular idea Need to perform certain behaviours over and over
or topic. again.

The person involved, often finds these thoughts Many compulsions deal with counting, ordering,
to be unpleasant and shameful. These thoughts checking, touching and washing
are unwanted and recurrent.

Other disorders in this category include hoarding disorder, trichotillomania (hair-pulling

disorder), excoriation (skin-picking) disorder.
◦ https://youtu.be/07-oawGxLQc
 Trauma- and Stressor-Related Disorders
Post-traumatic stress disorder (PTSD)
◦ PTSD symptoms vary widely but may include
✓ recurrent dreams
✓ Flashbacks
✓ impaired concentration
✓ emotional numbing.

◦ Adjustment Disorders and Acute Stress Disorder are

also included under this category.
FOUR CLUSTERS OF PTSD (ADDITIONAL)
• Re-experiencing symptoms: Flashbacks, physical or emotional
reactions when reminded of the traumatic event
• Avoidance symptoms: Avoiding anything that reminds them of the
event
• Negative changes: Mood swings, irritability, withdrawal from loved
ones
• Hyperarousal symptoms: Heightened startle response,
hypervigilance
THOUGHTS OF PERSON SUFFERING FROM PTSD:

◦ I didn't even want to go to sleep. The nightmares were so bad.

◦ That image kept coming back to me. I didn't want to remember it, but
there it was.
◦ I felt like I was right back there in the middle of that horrible day. The
smells, the sounds, it was so real.

https://youtu.be/QRXOvAGkot8

https://youtu.be/2KXtlIX_yUs
SOMATIC SYMPTONS AND OTHER
DISORDERS:
◦ These are conditions in which there are physical symptoms in the absence of a physical
disease.
◦ In these disorders, the individual has psychological difficulties and complains of physical
symptoms, for which there is no biological cause.
◦ These include:
➢Conversion disorders
➢Somatic symptom disorder
➢Illness anxiety disorder
SOMATIC SYMPTON DISORDER:

It involves a person having persistent body-related

symptoms which may or may not be related to any
serious medical condition.

Preoccupied with their symptoms and they continually

worry about their health and make frequent visits to
doctors.

They experience significant distress and disturbances in

their daily life.
Illness Anxiety Disorder:
◦ It involves persistent preoccupation
about developing a serious illness and
constantly worrying about this
possibility.

◦ Individuals with illness anxiety disorder

are overly concerned about
undiagnosed disease, negative
diagnostic results, do not respond to
assurance by doctors, and are easily
alarmed about illness such as on
hearing about someone else's ill-health
or some such news
CONVERSION DISORDER:
◦ The symptoms of conversion disorders are the reported loss
of part or all of some basic body functions.
◦ General symptoms reported in this disorder are:
◦ Paralysis
◦ Blindness
◦ Deafness
◦ Difficulty in walking
◦ These symptoms have no physical cause but may be a
response to stress and psychological problems.
◦ These symptoms often occur after a stressful experience and
may be quite sudden.
 DISSOCIATIVE DISORDERS:
◦ Disconnections between ideas and
emotions.
◦ Dissociation involves feelings of
unreality, depersonalisation, and
sometimes a loss or shift of identity.

◦ Involve disruptions or in a
person’s memory, identity,
emotion, perception, and
behavior
Dissociative Amnesia
◦ It is characterized by extensive but selective memory
loss that has no known organic cause (e.g., head injury).
◦ Some people cannot remember anything about their past.
Others can no longer recall specific events, people, places, or
objects, while their memory for other events remains intact.

◦ A part of dissociative amnesia is dissociative fugue.

◦ Essential feature of this could be an unexpected travel away
from home and workplace, the assumption of a new identity,
and the inability to recall the previous identity. The fugue
usually ends when the person suddenly ‘wakes up’ with no
memory of the events that occurred during the fugue. This
disorder is often associated with an overwhelming stress

https://youtu.be/Bc5Z-Ra5Uf8
https://www.youtube.com/watch?v=9xjHEt0kh9A
(fugue)
 Dissociative Identity Disorder
◦ It often referred to as multiple
personality, is the most dramatic of the
dissociative disorders.
◦ It is often associated with traumatic
experiences in childhood.
◦ In this disorder, the person assumes
alternate personalities that may or may not
be aware of each other.

https://youtu.be/KR-oZ3s-0Jk
https://youtube.com/shorts/FjkGPskxl9g?si=VRmJKjH1In
j3ooNr
 Depersonalization/Derealization
◦ It involves a dreamlike state in which the person
has a sense of being separated both from self and
from reality.
◦ In depersonalisation, there is a change of self-
perception, and the person’s sense of reality is
temporarily lost or changed
◦ Depersonalization/derealization disorder involves a
persistent or recurring feeling of being detached from
one’s body or mental processes, like an outside observer
of one's life (depersonalization), and/or a feeling of being
detached from one's surroundings (derealization).

what is derealisation / depersonalisation? - YouTube

https://youtu.be/mCcxWq_J0YU
Depersonalisation disorder: Why are some people unable to feel love? BBC News - YouTube
◦ https://youtu.be/XF2zeOdE5GY (summary of dissociative disorders)
◦ UNREAL: Life With Depersonalisation Disorder (A Short Film by Joe Perkins) – YouTube (DEPERSONALISATION)
 DEPRESSIVE DISORDERS:
◦ Depression covers a variety of negative moods and behavioral changes.

◦ Major depressive disorder is defined as a:

• Period of depressed mood
Other symptoms:
• Loss of interest or pleasure in most • Change in body weight
activities • Constant sleep problems
• Tiredness
• Inability to think clearly
• Greatly slowed behaviour
• Thoughts of death and suicide.
• Additionally it include excessive guilt or feelings of
worthlessness
◦ Factors Predisposing towards Depression :

✓Genetic make-up, or heredity is an important risk factor for major depression and other
depressive disorders.
✓Age is also a risk factor. For instance, women are particularly at risk during young adulthood,
while for men the risk is highest in early middle age.
✓Gender also plays a great role in this differential risk addition. For example, women in
comparison to men are more likely to report a depressive disorder.
✓Experiencing negative life events
✓Lack of social support

https://youtu.be/3-s0UIYc66U
https://youtu.be/HJzZREoEBMo
 BIPOLAR AND RELATED DISORDER:
▪ Bipolar I disorder involves both mania and depression, which are alternately present and
sometimes interrupted by periods of normal mood.
▪ People suffering from mania become euphoric (‘high’), extremely active, excessively talkative,
and easily distractible.
▪ Manic episodes rarely appear by themselves; they usually alternate with depression.
▪ Bipolar mood disorders were earlier referred to as manic-depressive disorders. Some
examples of types of bipolar and related disorders include
➢Bipolar I Disorder
➢Bipolar II disorder
➢Cyclothymic Disorder.
https://youtu.be/h_cSoU5kC70 (SILVER LINING)
https://www.youtube.com/watch?v=U3q3LCu9u0w
https://www.youtube.com/watch?v=qalDMvKysHg (CARTOON)
 SUICIDE:
◦ Suicide takes place throughout the lifespan. Suicide is a result of complex interface of
biological, genetic, psychological, sociological, cultural and environmental factors.
◦ Often, suicidal behavior indicates difficulties in problem-solving, stress management, and
emotional expression.
◦ Suicidal thoughts lead to suicidal action only when acting on these thoughts seems to be
the only way out of a person’s difficulties. These thoughts are heightened under acute
emotional and other distress.
◦ Therefore, improving identification, referral, and management of behaviour are crucial for
preventing suicide. Therefore, we need to identify vulnerability; comprehend the
circumstances leading to such behaviour and accordingly plan interventions.
◦ Suicides are preventable. There is a need for comprehensive multi-sectoral approach
where the government, media and civil society all play important role as stakeholders.
 SCHIZOPHRENIA:
Psychotic disorders in which personal, social
and occupational functioning get worse as a
result of disturbed thought processes, strange
perceptions, unusual emotional states, and
motor abnormalities.
 SCHIZOPHRENIA
SYMPTONS

POSITIVE NEGATIVE PSYCHOMOTOR

(excess of thoughts, (deficit of thoughts, SYMPTONS
emotions and emotions and
behavior) behviour)

1. DELUSIONS 1. ALOGIA
2. DISORGANISED CATATONIA
THINKING 2. BLUNTED
1. STUPOR
3. SPEECH EFFECT
4. HEIGHTENED 2. RIGIDITY
3. FLAT EFFECT
PERCEPTION 3. POSTURING
5. HALLUCIANTIONS 4. AVOLITION
 VISUAL
(seeing objects,
person or
patterns that
doesn’t exist)

AUDITORY
GUSTATORY
(second person
(Food or drink
and third
taste strange)
person)
HALLUCINATION
(perception that
occurs in the
absence of
OLFACTORY
external stimuli)
TACTILE
(Smell of smoke
or poison or ( feeling
something that sensation on
is not present) skin)

SOMATIC
(sensations
inside the body)
https://www.youtube.com/watch?v=lcZx6OCOTPc
https://www.youtube.com/watch?v=O3qyC6Z3t5g
◦ https://www.youtube.com/watch?v=ehhy-_Cg4QU
 PERSECUTION

REFERENCE

GRANDUER
DELUSION
False belief that is firmly held on CONTROL
inadequate grounds or evidence.
◦ Sarah, a 32-year-old woman, has been experiencing several troubling beliefs
over the past few months.

1. She believes that her coworkers are conspiring against her to get her fired and
that they are constantly watching her.
2. Sarah also feels that every time she sees a news report or hears a song on the
radio, these messages are specifically about her.
3. Additionally, she is convinced that she has been chosen for a special mission
and has extraordinary abilities that will soon be recognized by the world.
4. She also believes that her thoughts are being controlled by an unknown
external force, which is making her act in ways she doesn’t intend
 FORMAL THOUGHT
DISORDER

Don’t think logically

and speak in peculiar
way.

PERSEVERATION
ILLOGICAL (inappropriate
NEOLOGISMS
THINKING repetition of
thoughts)
NEGATIVE • Poverty of • Show less
speech feelings
SYMPTOMS:
BLUNTED
ALOGIA EFFECT

AVOLIATION
FLAT
EFFECT
• Inability to • NO
start or finish emotions
a task.
 PSYCHOMOTOR

MOVE LESS OR MAKE

WEIRD POSTURES CATATONIA

CATATONIC
RIGIDITY POSTURING
STUPOR

Motionless and silent for Maintaining a rigid, Assuming awkward, bizarre

long stretches of time. upright posture for hours positions
Neurodevelopmental disorders:

• ADHD: ATTENTION DEFICIT

HYPERACTIVITY DISORDER
• AUTISM SPECTRUM DISORDER
• INTELLECTUAL DISABILITY
• SPECIFIC LEARNING DISORDER
 ADHD: SYMPTOMS AUTISM:
1. INATTENTION:
• Impairments in social interaction
COMMONN COMPLAINTS: child does not listen, and communication skills:
cannot concentrate, does not follow instructions, is
disorganised, easily distracted, forgetful and quick Unresponsive to other people’s feelings,
to loose interest. unable to share experiences or emotions
with others, many of them never develop
2. HYPERACTIVITY: speech and those who do, have repetitive
and deviant speech patterns, does not
Are in constant motion, child may fidget, squirm, understand non-verbal communication
climb and run around the room aimlessly, Sitting
still through a lesson is impossible for them • Stereotyped patterns of
behaviours, interests and
3. IMPULSIVITY : activities:

Unable to control their reactions, difficult to wait Stereotyped body movements, motor
for their turns, have difficulty resisting immediate movements such as hand flapping or self-
temptation injurious such as banging their head against
the wall
https://www.youtube.com/watch?v=j3PrAqJ-H9k
(AUTISM )
 EATING DISORDERS:
anorexia nervosa, the individual has a distorted body image
(overweight), Often refusing to eat, exercising compulsively and
developing unusual habits (refusing to eat in front of others, lose large
amounts of weight and even starve herself/himself to death)

bulimia nervosa, eat excessive amounts of food, then purge out food
by using medicines.

binge eating, there are frequent episodes of out-of-control eating, eat

at a higher speed than normal and continues eating till s/he feels
uncomfortably full, large amount of food eaten even when the individual
is not feeling hungry.