UNDERSTANDING

PSYCHOLOGICAL DISORDERS
 REMEMBER!!!!!

WHAT YOU ARE ABOUT TO LEARN DOES NOT PROVIDE YOU WITH NECESSARY SKILLS
FOR EITHER DIAGNOSING OR TREATING DISORDERS

YOU ARE NOT QUALIFIED OR EXPERIENCED TO ATTEMPT TO DIAGNOSE OR TREAT YOURSELF OR OTHERS

IF NEEDED, REACH OUT TO A PROFESSIONAL COUNSELLOR/CLINICAL PSYCHOLOGIST/PSYCHIATRIST

WHAT WE LEARN IN THIS CHAPTER:

▪ UNDERSTAND BASIC ISSUES RELATING TO ABNORMAL BEHAVIOUR AND CRITERIA USED IN IDENTIFYING THEM

▪ APPRECIATE THE VARIOUS FACTORS WHICH CAUSE ABNORMAL BEHAVIOUR & EXPLAIN THE MODELS ABOUT THEM

▪ DESCRIBE THE VARIOUS TYPES OF PSYCHOLOGICAL DISORDERS AND THEIR SYMPTOMS

What is normal?
 PSYCHOLOGICAL DISORDERS
(ABNORMALITY)

ABNORMAL BEHAVIOUR MALADAPTIVE BEHAVIOUR

(Deviation from norms) (unhealthy, does not foster wellbeing)

4 D’s

DEVIANT DISTRESS DYSFUNCTION DANGER

AWAY FROM NORMS CAUSE DISTRESS TO SELF AFFECTS DAY-TO DAY TO SELF
DIFFERENT, EXTREME, UNUSUAL, AND(OR) OTHERS FUNCTIONING OR TO OTHERS
EVEN BIZARRE

STIGMA - hesitation to seek help - ashamed of mental illness ( F I R - Frequency, Intensity and Recovery time)
 REFORM MOVEMENT/ AGE OF REASON &
INTERACTIONAL APPROACH RECENT
ENLIGHTENMENT
BIO-PSYCHO-SOCIAL APPROACH SCIENTIFIC UNDERSTANDING-
DEINSTITUTIONALISATION
RENAISSANCE MODERN
JOHANN WEYER - HUMANISM
MEDICAL TREATMENT (NOT THEOLOGY)
MIDDLE AGES
DARK AGES-RETURN OF SUPERSTITION& DEMONOLOGY,
WITCH HUNTS
ORGANISMIC
HIPPOCRATES - IMBALANCE IN FOUR HUMORS
AYURVEDA - IMBALANCE IN TRIDOSHA
PSYCHOLOGICAL
ERRORS & INADEQUACIES IN INDIVUAL’S HISTORICAL
THINKING,FEELING & PERCEPTION BACKGROUND
BIOLOGICAL/ IN THE
ORGANIC- MALFUNCTIONING OF BODY & BRAIN UNDERSTANDING
PSYCHOLOGICAL
SUPERNATURAL - EXORCISM/MAGICAL/EVIL SPIRITS
ANCIENT DISORDERS
 INTERACTIONAL APPROACH
BIO-PSYCHO-SOCIAL APPROACH

BIOLOGICAL, PSYCHOLOGICAL
AND SOCIAL FACTORS ALL THREE
INTERACT IN INFLUENCING THE
EXPRESSION AND OUTCOME OF
PSYCHOLOGICAL DISORDERS
Classifications of disorders:
Classification of disorders consists of a list of psychological disorders grouped into
various classes on the basis of some shared characteristics like clinical features or
symptoms, including diagnostic guidelines.
Classifications are useful because
1. they enable users like psychologists, psychiatrists and social workers to
communicate with each other about the disorder
2. help in understanding the causes of psychological disorders.
The Major classifications followed are:
1. The American Psychiatric Association (APA)- Diagnostic and Statistical
Manual of Mental Disorders, currently (DSM-V).
2. 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 the World Health Organisation (WHO).
 FACTORS WHICH INFLUENCE PSYCHOLOGICAL DISORDERS
▪ BIOLOGICAL MODEL
▪ PSYCHOLOGICAL MODEL
▪ SOCIOCULTURAL MODEL
▪ DIATHESIS STRESS MODEL

Biological Model believes that abnormal behaviour has a biochemical or physiological basis.
Biological factors such as faulty genes, endocrine imbalances, malnutrition, injuries and
other conditions may be potential causes of abnormal behaviour.
Examples:
Faulty genes may cause problems like Down’s syndrome
Neurotransmitter imbalances are linked to psychological problems.
Eg. Anxiety disorders - linked to low activity of neurotransmitter GABA,
Schizophrenia - linked to excess activity of dopamine,
Depression linked to low activity of serotonin
Psychological Model: According to this model, psychological problems are caused by
a. Psychological factors like inadequacies in the way an individual thinks, feels, or perceives the world
b. interpersonal factors like maternal deprivation (separation from the mother, or lack of warmth and
stimulation during early years of life), faulty parent-child relationships (rejection, overprotection, overpermissiveness,
faulty discipline, etc.), maladaptive family structures (inadequate or disturbed family), and severe stress.
The four major psychological models are :
1. Psychodynamic model: repressed unconscious motives and desires, often from traumatic childhood experiences
lead to intra-psychic conflicts, which cause psychological problems.
2. Behavioural Model : Learning maladaptive behaviours due to faulty conditioning (classical/operant) or from
negative role models ( observational learning) causes psychological disorders.
3. Humanistic- Existential Model: Individuals naturally seek to fulfill one’s full potential and seek personal growth,
i.e., self actualization. When this need is frustrated, it causes psychological distress.
Existentialists - We have total freedom from birth to give meaning to our existence. Those who avoid this
responsibility lead empty inauthentic lifes
1. Cognitive Model : When individuals hold illogical, irrational and negative ideas( cognitive distortions)about the
world and themselves it causes psychological distress.
 SOCIO-CULTURAL MODEL
▪ Abnormal behaviour is a reflection of the social & cultural factors that influence
us

▪ Social and Cultural factors like war, violence, discrimination, poverty, deprivation
can lead to psychological problems

▪ Societal forces such as family structures, communication, societal labels and roles
can influence psychological functioning;

▪ Example:
Enmeshed family structures - leads to dependent and insecure individuals
Isolation & Lack of social support - More depressed

▪ Societal Labels and roles - example “crazy” “mentally ill”-

make the individuals play the sick role.
 DIATHESIS STRESS MODEL

DIATHESIS
GENES, BRAIN ABNORMALITIES,
NEUROTRANSMITTER IMBALANCE

VULNERABILITY
DUE TO THE DIATHESIS
PATHOGENIC
STRESSORS
TRAUMA,
ABUSE,
LOSS/FAILURE
PSYCHOLOGICAL
DISORDER
 Beyonce
Emma Watson
Oprah Winfrey
Deepika PadukonE
Dwayne Johnson

John Nash
Nobel Laureate for Game theory
 GENERALISED ANXIETY
DISORDER PHOBIA
ANXIETY DISORDERS

SEPARATION ANXIETY
PANIC DISORDER
(worry, fear, physical tension) DISORDER

Triskaidekaphobia (fear of the

number 13, including the year
TRAUMA AND STRESS RELATED DISORDERS 2013).
(stressful experiences)
POST TRAUMATIC STRESS
DISORDER

ACUTE STRESS DISORDER ADJUSTMENT DISORDER

OBSESSIVE COMPULSIVE & RELATED DISORDER

(repetitive behaviour & thought)
OBSESSIVE & COMPULSIVE DISORDER

EXCORIATION TRICHOTILLOMANIA HOARDING DISORDER

 SOMATIC SYMPTOM & RELATED DISORDER ( Physical symptoms in the absence of any organic cause)

SOMATIC SYMPTOM ILLNESS ANXIETY CONVERSION

DISORDER DISORDER DISORDER

DISSOCIATIVE DISORDERS - loss or shift in Identity & sense of self)

DEPERSONALISATION
DISSOCIATIVE
DISSOCIATIVE AMNESIA DISORDER
IDENTITY DISORDER
( with Dissociative fugue)

DEPRESSIVE DISORDERS -intense sadness, hopelessness and worthlessness

MAJOR DEPRESSIVE
DISORDER

BIPOLAR & RELATED DISORDERS - Dramatic mood changes between depression and & mania
BIPOLAR I BIPOLAR II CYLCOTHYMIC
DISORDER DISORDER DISORDER
 SUICIDE PREVENTION
WHAT MAKES THEM HOW CAN I HELP? - At the Social level
VULNERABLE? HOW TO IDENTIFY ▪ Early identification, intervention and
(RISK FACTORS) VULNERABLE INDIVIDUALS? support
▪ Creating awareness about mental health
▪ Depression, alcohol abuse ▪ Sudden or unexplained ▪ Increasing accessibility to trained mental
▪ Negative/traumatic decline in functioning( health professionals
experiences academic or work) ▪ Responsible media (& social media)
(Violence, abuse, disaster, ▪ Lack of interest in portrayal
loss or common activities ▪ Of such incidences
isolation) ▪ Decreasing effort ▪ Provide Care and community support
▪ Previous suicidal attempt ▪ Declining ▪ Limit access to risky means
grades/productivity
WHAT INCREASES ▪ Social withdrawal & HOW CAN I HELP MYSELF AND MY FRIENDS?
VULNERABILITY isolating oneself ▪ Count your positive life experiences-
▪ Difficulties in problem ▪ Increased Unexplained practice gratitude
solving, difficulties in absenteeism ▪ Aim for holistic development( physical,
emotional expression, ▪ Emotional outburst and mental and social skills)
▪ Inadequate coping to misbehaviour ▪ Form Genuine relationships with trusting
stress ▪ Substance abuse communication
▪ Lack of social support ▪ Suicidal ideation ▪ Set realistic, meaningful, achievable and
▪ Stigma to mental illness measurable goals
 SCHIZOPHRENIA

Schizophrenia : A group of psychotic disorders in which personal, social and occupational functioning
deteriorate as a result of disturbed thought processes, strange perceptions, unusual emotional states,
and motor abnormalities.

Symptoms of Schizophrenia
The symptoms of schizophrenia can be grouped into three categories, viz.
positive symptoms (i.e. excesses of thought, emotion, and behaviour),
negative symptoms (i.e. deficits of thought, emotion, and behaviour), and
psychomotor symptoms. (i.e., bizarre or weird movements and postures)
 POSITIVE SYMPTOMS OF SCHIZOPHRENIA

Delusions: False belief that Hallucinations

Formal thought disorder
is firmly held on inadequate Perceptions that occur in the absence of external
grounds. Not affected by stimuli. Not be able to think logically and may
rational argument, and has no speak in peculiar ways which make
basis in reality. Auditory hallucinations - hear sounds or voices communication extremely difficult.
that speak words, phrases and sentences directly
1.delusions of persecution to the patient (second person hallucination) or talk Loosening of associations, derailment
(beings spied on, plotted to one another referring to the patient as s/he (third - rapidly shifting from one topic to
against), person hallucination). another so that the normal structure of
thinking is muddled and becomes
2. delusions of grandeur Tactile hallucinations (i.e. forms of tingling, illogical
( believing that one has burning),
Neologisms - inventing new words or
special powers), Somatic hallucinations (i.e. something happening phrases
3. delusions of control inside the body such as a snake crawling inside
one’s stomach), Perseveration - persistent and
( somebody is controlling inappropriate repetition of the same
ones’s thoughts and actions) Visual hallucinations (i.e. vague perceptions of thoughts (perseveration).
colour or distinct visions of people or objects)
4. delusions of reference
(attaching special meanings Gustatory hallucinations (i.e. food or drink taste
to events and actions of strange),
others). Olfactory hallucinations (i.e. smell of poison or
smoke). Inappropriate affect, i.e .they show
emotions that are unsuited to the situation
 Negative symptoms
Psychomotor symptoms:
p‘ athological deficits and include poverty of
speech, blunted and flat affect, loss of Move less spontaneously or make odd
volition, and social withdrawal. grimaces and gestures. These symptoms
may take extreme forms known as
Alogia or poverty of speech, i.e. a catatonia.
reduction in speech and speech content.
Catatonic stupor - remain motionless
Blunted affect: show less anger, sadness, and silent for long stretches of time.
joy, and other feelings than most people do.
Catatonic rigidity, i.e. maintaining a
Flat Effect: Showing no emotions at all. rigid, upright posture for hours.
Avolition, or apathy and an inability to Catatonic posturing, i.e. assuming
start or complete a course of action, may awkward, bizarre positions for long
withdraw socially and become totally periods
focused on their own ideas and fantasies.
 NEURODEVELOPMENTAL DISORDER
▪ Manifest in the early stage of development.
▪ Symptoms appear before the child enters school or during the early stage of schooling.
▪ Hampering personal, social, academic and occupational functioning.
▪ Deficits or excesses or delays in achieving age-appropriate behaviours

➢ Attention-Deficit/Hyperactivity Disorder (ADHD),

➢ Autism Spectrum Disorder

➢ Intellectual Disability

➢ Specific Learning Disorder

ADHD: Attention Deficit Hyperactivity Disorder:

The two main features of ADHD are inattention & hyperactivity, impulsivity.
Inattention - difficulty to sustain mental effort during work or play or in following instructions. Common complaints are that the
child does not listen, cannot concentrate, does not follow
instructions, is disorganised, easily distracted, forgetful, does not finish assignments, and is quick to lose interest in boring
activities.

Impulsivity - unable to control their immediate reactions or to think before they act. They find it difficult to wait or take turns,
have difficulty resisting immediate temptations or delaying gratification. Minor mishaps such as knocking things, more serious
accidents and injuries can also occur.
Hyperactivity = Are in constant motion, difficulty in sitting still, may fidget, squirm, climb and run around the room aimlessly.
Parents and teachers describe them as ‘driven by a motor’, and talk incessantly.

Boys are four times more likely to be given this diagnosis than girls.
 Autistic spectrum disorder
Autism is one of the most common ASD.
Characteristics:
Marked difficulties in social interaction : -
Difficulties in relating to other people, unable to initiate social behaviour and seem unresponsive to other
people’s feelings.
Serious abnormalities in communication and language:-
Many autistic children never develop speech and those who do, have repetitive and deviant speech patterns.
Unable to share experiences or emotions with others, a restricted range of interests, and strong desire for
routine.
Show narrow patterns of interests and repetitive behaviours such as lining up objects or stereotyped body
movements such as rocking., or may be self-stimulatory such as hand flapping or self-injurious such as banging
their head against the wall.
About 70 per cent of children with autism are also mentally retarded.
Intellectual disability refers to

▪ Below average intellectual functioning (with an IQ of approximately 70 or below), and d

▪ Deficits or Impairments in adaptive behaviour (i.e. in the areas of communication, self-care, home living,
social/interpersonal skills, functional academic skills, work, etc.)
▪ Which are manifested before the age of 18 years.

Specific learning disorder

▪ Experiences difficulty in perceiving or processing information efficiently and accurately.
▪ Manifested during early school years and the individual encounters problems in basic skills in reading,
writing and/or mathematics.
▪ Tends to perform below average for her/his age.

▪ Specific learning disorder is likely to impair functioning and performance in activities/ occupations
dependent on the related skills.

However, individuals may be able to reach acceptable performance levels with additional inputs and efforts.
DISRUPTIVE & IMPULSE CONTROL & CONDUCT DISORDERS

▪ OPPOSITIONAL DEFIANT DISORDER

▪ CONDUCT and ANTI SOCIAL DISORDER

 Oppositional Defiant Disorder (ODD) Children display age-
inappropriate amounts of stubbornness, are irritable, defiant,
disobedient, and behave in a hostile manner. They do not see
themselves as angry but consider themselves as right.
Conduct Disorder and Antisocial Behaviour –Age –inappropriate actions
and attitudes that violate family expectations, societal norms, aggressive
actions that cause or threaten harm to people or animals, non-aggressive
conduct that causes property damage, major deceitfulness or theft, and
serious rule violations.
Children show many different types of aggressive behaviour, such as
verbal aggression (i.e. name-calling, swearing),
physical aggression (i.e. hitting, fighting),
hostile aggression (i.e. directed at inflicting injury to others), and
proactive aggression (i.e. dominating and bullying others without
provocation).
 Feeding and Eating disorders
(mostly seen in the young)
Anorexia nervosa -
▪ Has a distorted body image that leads her/him to see herself/himself as overweight.
▪ Often refusing to eat, exercising compulsively
▪ Developing unusual habits such as 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 her/ his body of food by using medicines such as laxatives or
diuretics or by vomiting.
▪ Feels disgusted and ashamed when s/he binges - relieved of tension and negative emotions after purging.
Binge eating
▪ Frequent episodes of out-of-control eating.
▪ Continue to eat even when uncomfortable and when not hungry
Substance-use Disorders :

Disorders relating to maladaptive behaviours resulting from regular , consistent and addictive
use of the substance involved are called substance abuse disorders. This includes excessive intake
of high calorie food resulting in extreme obesity or involving the abuse of psychoactive
substances such as alcohol or cocaine.

Substance dependence: It is characterized by intense craving, tolerance, withdrawal symptoms

and compulsive drug-taking.

Intense craving for the substance to which the person is addicted,

Tolerance - the person has to use more and more of a substance to get the same effect.

Withdrawal symptoms - physical symptoms that occur when a person stops or cuts down on the
use of a psychoactive substance.
 Alcohol abuse and dependence –
▪ Characterized by compulsive alcoholism , tolerance and withdrawal symptoms when stops/reduces intake.
▪ Effects : Excessive drinking can seriously damage physical health.
▪ Seriously affects millions of families, social relationships and careers.
▪ Intoxicated drivers are responsible for many road accidents.
▪ Serious effects on the children of persons with this disorder. These children have higher rates of psychological
problems, particularly anxiety, depression, phobias and substance-related disorders.

Heroin abuse and dependence - characterized by Cocaine abuse and dependence. - characterized by
compulsive drug taking and the individual shows compulsive drug taking and the individual shows tolerance
tolerance and shows withdrawal symptoms when and shows withdrawal symptoms when stops/reduces
stops/reduces intake. intake.
Effects : Danger of heroin abuse is an overdose, which Effects: Causes problems in short-term memory and
slows down the respiratory centres in the brain, almost attention, stopping it results in feelings of depression,
paralysing breathing, and in many cases causing death. fatigue, sleep problems, irritability and anxiety.