UNIT II

INTRODUCTION TO ABNORMAL PSYCHOLOGY

ABNORMAL PSYCHOLOGY
Abnormal psychology is a fascinating field that explores various psychological disorders
and atypical patterns of behavior, cognition, and emotion.
It delves into the causes, symptoms, and treatments of conditions such as anxiety
disorders, mood disorders like depression and bipolar disorder, schizophrenia, personality
disorders, and more.
Researchers and clinicians in this field work to understand how these disorders impact
individuals' lives and seek ways to alleviate their suffering and improve their quality of
life.
By studying abnormal psychology, we gain insights into the complexities of the human
mind and strive for compassionate and effective approaches to mental health care.

NATURE OF PSYCHOLOGICAL DISORDERS

Psychological disorders are characterized by a range of features that distinguish them from
normal variations in thoughts, emotions, and behaviors. Some key characteristics include:

1. Distress or Dysfunction: Psychological disorders typically involve distress, discomfort, or

impairment in functioning. Individuals may experience significant emotional distress, such as
sadness, anxiety, or agitation, or they may struggle to carry out daily activities, maintain
relationships, or fulfill responsibilities.

2. Deviance: Psychological disorders often involve behavior, thoughts, or emotions that deviate
from societal or cultural norms. These deviations may be considered unusual, inappropriate, or
unexpected within a particular cultural context.

3. Duration and Persistence: Psychological disorders are characterized by symptoms that

persist over time and are not transient or temporary. They may be chronic, recurrent, or episodic
in nature, impacting the individual's functioning over an extended period.

4. Maladaptive Patterns: Psychological disorders are marked by maladaptive patterns of

thoughts, emotions, or behaviors that interfere with the individual's ability to adapt to life's
challenges and demands. These patterns may contribute to further distress or impairment
5. Biopsychosocial Causes (Etiology): Psychological disorders have multifaceted etiologies,
involving interactions between biological, psychological, and social factors. Biological factors
may include genetic predispositions, neurochemical imbalances, or brain abnormalities.
Psychological factors may involve early life experiences, personality traits, and coping
mechanisms. Social factors may include trauma, stressors, socioeconomic status, and cultural
influences.

6. Variability and Heterogeneity: Psychological disorders encompass a diverse range of

conditions with varying symptoms, severity levels, and presentations. Individuals with the same
diagnosis may exhibit different symptom patterns, response to treatment, and course of illness.

7. Diagnosis and Classification: Psychological disorders are classified and diagnosed using
standardized criteria outlined in diagnostic manuals such as the Diagnostic and Statistical
Manual of Mental Disorders (DSM) or the International Classification of Diseases (ICD). These
criteria help clinicians identify and categorize specific disorders based on symptom patterns and
clinical presentations.

Understanding these characteristics is crucial for accurately assessing, diagnosing, and treating
psychological disorders, as well as promoting mental health awareness and reducing stigma
surrounding mental illness.

TYPES OF PSYCHOLOGICAL DISORDERS

1) MOOD DISORDERS
Mood disorders are a category of psychological disorders characterized by significant
disturbances in a person's emotional state, leading to persistent changes in mood that impair daily
functioning and overall quality of life.
1. Major Depressive Disorder (MDD):
- Major depressive disorder, commonly known as depression, is one of the most prevalent
mood disorders worldwide.
- It is characterized by persistent feelings of sadness, hopelessness, and loss of interest or
pleasure in activities that were once enjoyable.
- Other symptoms may include changes in appetite or weight, sleep disturbances, fatigue,
feelings of worthlessness or guilt, difficulty concentrating, and thoughts of death or suicide.
- To meet the diagnostic criteria for MDD, symptoms must be present most of the day, nearly
every day, for at least two weeks, and significantly impair functioning.
 - Treatment typically involves a combination of psychotherapy (such as cognitive-behavioral
therapy or interpersonal therapy) and medication (such as antidepressants).

2. Bipolar Disorder:
- Bipolar disorder is characterized by recurrent episodes of both depression and mania (or
hypomania, a less severe form of mania).
- During manic episodes, individuals may experience elevated mood, inflated self-esteem,
increased energy and activity levels, racing thoughts, impulsivity, and decreased need for sleep.
- During depressive episodes, symptoms are similar to those of major depressive disorder.
- There are several subtypes of bipolar disorder, including bipolar I disorder (which involves
full-blown manic episodes) and bipolar II disorder (which involves hypomanic episodes and
depressive episodes).
- Treatment typically involves mood stabilizers (such as lithium or anticonvulsants) to manage
mood swings, along with psychotherapy and sometimes antidepressants (with caution to avoid
triggering manic episodes).

3. Persistent Depressive Disorder (Dysthymia):

- Persistent depressive disorder, also known as dysthymia, is a chronic form of depression
lasting for at least two years in adults (or one year in children and adolescents).
- Symptoms of dysthymia are similar to those of major depressive disorder but are less severe
and more persistent.
- Individuals with dysthymia may experience fluctuations in mood, with periods of feeling
slightly better followed by worsening symptoms.
- Dysthymia can lead to significant impairment in social, occupational, and educational
functioning if left untreated.
- Treatment typically involves psychotherapy, support groups, and sometimes medication
(similar to the treatment approach for major depressive disorder).

4. Other Specified and Unspecified Depressive Disorders:

- In addition to the specific mood disorders mentioned above, the DSM-5 includes categories
for other specified and unspecified depressive disorders.
- These categories are used when symptoms do not fully meet the criteria for a specific mood
disorder but still cause distress or impairment.
 - Examples include depressive disorder due to another medical condition, substance-induced
depressive disorder, and other specified depressive disorder with atypical features.

5. Cyclothymic Disorder:
- Cyclothymic disorder is characterized by chronic fluctuations in mood involving numerous
periods of hypomanic symptoms and depressive symptoms that do not meet the criteria for a
major depressive episode.
- Symptoms of cyclothymic disorder are milder and less severe than those of bipolar disorder
but still cause significant distress and impairment.
- The disorder typically lasts for at least two years in adults (or one year in children and
adolescents) without a symptom-free period lasting longer than two months.
- Treatment may involve mood stabilizers, psychotherapy, and lifestyle modifications to
manage mood fluctuations and promote stability.

2)ANXIETY DISORDERS
Anxiety disorders are a group of mental health conditions characterized by excessive, persistent,
and debilitating feelings of anxiety and fear. These disorders can significantly impair daily
functioning, relationships, and overall quality of life.
1. Generalized Anxiety Disorder (GAD):
- Generalized anxiety disorder is characterized by excessive worry and apprehension about
various aspects of life, such as work, health, finances, and relationships.
- Individuals with GAD often experience uncontrollable and intrusive thoughts, accompanied
by physical symptoms such as muscle tension, restlessness, fatigue, irritability, difficulty
concentrating, and sleep disturbances.
- The excessive worry and anxiety are typically present on most days for at least six months
and cause significant distress or impairment in social, occupational, or other important areas of
functioning.
- Treatment for GAD often involves a combination of psychotherapy (such as cognitive-
behavioral therapy or mindfulness-based therapy) and medication (such as selective serotonin
reuptake inhibitors or benzodiazepines).

2. Panic Disorder:
- Panic disorder is characterized by recurrent and unexpected panic attacks, which are sudden
episodes of intense fear or discomfort that reach a peak within minutes.
 - Symptoms of panic attacks may include palpitations, sweating, trembling, shortness of breath,
chest pain, nausea, dizziness, and feelings of impending doom or loss of control.
- Individuals with panic disorder often develop anticipatory anxiety about experiencing future
panic attacks, leading to avoidance of certain situations or environments.
- Treatment for panic disorder may include cognitive-behavioral therapy (specifically panic-
focused cognitive-behavioral therapy), medication (such as antidepressants or benzodiazepines),
and relaxation techniques to manage symptoms during panic attacks.

3. Social Anxiety Disorder (Social Phobia):

- Social anxiety disorder involves intense fear or anxiety about social situations in which the
individual may be scrutinized, judged, or embarrassed by others.
- Common social situations that provoke anxiety may include public speaking, meeting new
people, eating or drinking in public, and participating in group activities.
- Symptoms of social anxiety disorder may include blushing, sweating, trembling, rapid
heartbeat, nausea, and avoidance of social situations.
- Treatment for social anxiety disorder often involves cognitive-behavioral therapy (such as
exposure therapy or cognitive restructuring) to challenge and modify maladaptive thought
patterns and behaviors, along with medication (such as selective serotonin reuptake inhibitors).

4. Specific Phobias:
- Specific phobias are characterized by intense and irrational fears of specific objects,
situations, or activities.
- Common phobias include fear of heights (acrophobia), fear of flying (aviophobia), fear of
spiders (arachnophobia), fear of needles (trypanophobia), and fear of enclosed spaces
(claustrophobia), among others.
- Individuals with specific phobias may go to great lengths to avoid the feared stimulus,
leading to significant disruption in daily life.
- Treatment for specific phobias often involves exposure therapy, a form of cognitive-
behavioral therapy that gradually exposes the individual to the feared stimulus in a controlled
and systematic manner to reduce anxiety responses.
5. Agoraphobia:
- Agoraphobia involves intense fear or anxiety about being in situations or places where escape
might be difficult or embarrassing, or where help may not be available in the event of a panic
attack or other anxiety symptoms.
- Common situations that may trigger agoraphobia include crowded spaces, public
transportation, open spaces, enclosed spaces, and being outside the home alone.
- Individuals with agoraphobia may avoid leaving their homes altogether or may only venture
out with a trusted companion.
- Treatment for agoraphobia often involves a combination of cognitive-behavioral therapy
(including exposure therapy and cognitive restructuring) and medication (such as antidepressants
or anti-anxiety medications).

6. Selective Mutism:
- Selective mutism is characterized by consistent failure to speak in specific social situations
(such as school or social gatherings) despite speaking in other situations (such as at home).
- Selective mutism typically begins in childhood and can persist into adolescence and
adulthood if left untreated.
- The underlying cause of selective mutism is not fully understood but may involve social
anxiety, shyness, communication disorders, or other factors.
- Treatment for selective mutism often involves behavioral interventions, speech therapy, and
support from parents, teachers, and mental health professionals to help the individual gradually
overcome their fear of speaking in certain situations.

7. Separation Anxiety Disorder:

- Separation anxiety disorder is characterized by excessive fear or anxiety about separation
from attachment figures (such as parents or caregivers) or from home.
- Symptoms of separation anxiety disorder may include recurrent distress when anticipating or
experiencing separation from attachment figures, excessive worry about harm befalling them or
themselves, refusal to be alone, nightmares about separation, and physical symptoms such as
headaches or stomachaches.
- Separation anxiety disorder is most commonly diagnosed in childhood but can also occur in
adolescence or adulthood.
 - Treatment for separation anxiety disorder may involve cognitive-behavioral therapy (including
exposure therapy and relaxation techniques), family therapy, and gradual exposure to separation
situations to build coping skills and reduce anxiety.

3)SCHIZOPHRENIA SPECTRUM DISORDERS

Schizophrenia spectrum disorders represent a group of chronic and severe mental health
conditions characterized by disturbances in thinking, perception, emotions, and behavior.
Schizophrenia is the most well-known and studied disorder within this spectrum, but it also
includes other related conditions with similar features.
1. Schizophrenia:
- Schizophrenia is a chronic and severe mental disorder that affects how a person thinks, feels,
and behaves.
- Symptoms of schizophrenia typically include positive symptoms (such as hallucinations,
delusions, disorganized thinking or speech, and grossly disorganized or catatonic behavior) and
negative symptoms (such as flattened affect, avolition, alogia, and anhedonia).
- The onset of schizophrenia typically occurs in late adolescence or early adulthood, although it
can develop at any age.
- The course of schizophrenia is heterogeneous, with some individuals experiencing episodic
symptom exacerbations and remissions, while others have a more chronic and continuous course.
- Treatment for schizophrenia often involves a combination of antipsychotic medications,
psychotherapy (such as cognitive-behavioral therapy or supportive therapy), psychosocial
interventions (such as family therapy or supported employment), and community support
services.

2. Schizoaffective Disorder:
- Schizoaffective disorder is characterized by a combination of schizophrenia symptoms (such
as hallucinations, delusions, disorganized thinking, or negative symptoms) and mood disorder
symptoms (such as major depressive episodes, manic episodes, or mixed episodes).
- The diagnosis of schizoaffective disorder requires that the mood symptoms be present for a
substantial portion of the illness and that psychotic symptoms occur in the absence of prominent
mood symptoms for a significant period.
- Schizoaffective disorder can be classified into bipolar type (if manic or mixed episodes are
present) or depressive type (if only major depressive episodes are present).
 - Treatment for schizoaffective disorder often involves a combination of antipsychotic
medications, mood stabilizers or antidepressants, and psychotherapy tailored to both the
psychotic and mood symptoms.

3. Schizophreniform Disorder:
- Schizophreniform disorder is characterized by symptoms similar to those of schizophrenia
but with a shorter duration (between one to six months) and less impairment in functioning.
- Like schizophrenia, schizophreniform disorder involves the presence of at least two of the
following symptoms: delusions, hallucinations, disorganized speech, disorganized or catatonic
behavior, or negative symptoms.
- If symptoms persist beyond six months, the diagnosis may be changed to schizophrenia.
- Treatment for schizophreniform disorder is similar to that for schizophrenia and may involve
antipsychotic medications, psychotherapy, and supportive interventions.

4. Brief Psychotic Disorder:

- Brief psychotic disorder is characterized by the sudden onset of psychotic symptoms (such as
hallucinations, delusions, disorganized speech, or grossly disorganized or catatonic behavior)
that last for less than one month.
- The symptoms of brief psychotic disorder may be preceded by a significant stressor or
trauma, such as bereavement, interpersonal conflict, or substance intoxication or withdrawal.
- Although the duration of symptoms is brief, the impact on the individual and their functioning
can be significant.
- Treatment for brief psychotic disorder often involves addressing the underlying stressor,
supportive interventions, and sometimes short-term use of antipsychotic medications.

5. Schizotypal Personality Disorder:

- Schizotypal personality disorder is characterized by eccentric behavior, unusual beliefs or
experiences, interpersonal difficulties, and social isolation.
- Individuals with schizotypal personality disorder may exhibit odd or eccentric speech, beliefs,
or appearance, as well as unusual perceptual experiences or paranoid ideation.
- While schizotypal personality disorder shares some features with schizophrenia, it is
considered a personality disorder rather than a psychotic disorder.
 - Treatment for schizotypal personality disorder may involve psychotherapy (such as cognitive-
behavioral therapy or supportive therapy) to address maladaptive patterns of thinking and
behavior, as well as social skills training to improve interpersonal functioning.

4) OBSESSIVE-COMPULSIVE DISORDER (OCD)

Obsessive-compulsive disorder (OCD) is a mental health condition characterized by intrusive,
unwanted thoughts or obsessions, often accompanied by repetitive behaviors or compulsions that
individuals feel driven to perform in response to these obsessions.
1. Obsessions:
- Obsessions are intrusive and persistent thoughts, images, or urges that cause significant
anxiety or distress.
- Common obsessions include fears of contamination or germs, doubts about safety or harm,
concerns about order or symmetry, taboo or forbidden thoughts, and aggressive or violent
impulses.
- Individuals with OCD may recognize that their obsessions are irrational, but they find it
difficult to control or ignore them.

2. Compulsions:
- Compulsions are repetitive behaviors or mental acts that individuals feel driven to perform in
response to their obsessions.
- Compulsions are aimed at reducing or preventing anxiety or distress or preventing a dreaded
event or situation.
- Common compulsions include washing or cleaning, checking, counting, arranging or
organizing, repeating actions or words, and seeking reassurance.

3. Types of OCD:
- OCD symptoms can manifest in various ways, leading to different subtypes or themes of the
disorder.
- Common subtypes of OCD include contamination OCD (obsessions related to cleanliness and
hygiene, accompanied by compulsive washing), checking OCD (obsessions related to safety or
harm, accompanied by compulsive checking), symmetry OCD (obsessions related to order or
symmetry, accompanied by compulsive arranging), and hoarding OCD (obsessions related to
acquiring or discarding items, accompanied by compulsive saving or collecting).
4. Treatment Approaches:
- Cognitive-behavioral therapy (CBT), particularly exposure and response prevention (ERP), is
considered the most effective psychotherapy for OCD.
- ERP involves gradually exposing the individual to their obsessions (exposure) while refraining
from engaging in their compulsions (response prevention), thereby helping them learn to tolerate
and reduce anxiety without resorting to compulsive behaviors.
- Medication, particularly selective serotonin reuptake inhibitors (SSRIs), is often prescribed to
alleviate symptoms of OCD, especially when combined with CBT.
- Other treatment options for OCD may include acceptance and commitment therapy (ACT),
dialectical behavior therapy (DBT), mindfulness-based interventions, and support groups.

5) STRESS RELATED DISORDERS

Stress-related disorders encompass a group of mental health conditions that are triggered or
exacerbated by exposure to stressful or traumatic events. These disorders can have a profound
impact on an individual's emotional well-being, behavior, and overall functioning.

1. Post-Traumatic Stress Disorder (PTSD):

- PTSD is a mental health condition that can develop after exposure to a traumatic event or
series of events involving actual or threatened death, serious injury, or sexual violence.
- Symptoms of PTSD may include intrusive memories, flashbacks, nightmares, avoidance of
trauma reminders, negative changes in mood or cognition, and heightened arousal or reactivity.
- PTSD symptoms can persist for months or years after the traumatic event and can
significantly impair an individual's ability to function in daily life.
- Risk factors for PTSD include the severity and duration of the trauma, personal vulnerability
factors (such as prior trauma exposure, genetics, or temperament), lack of social support, and
ongoing stressors.
- Treatment for PTSD often involves psychotherapy (such as cognitive-behavioral therapy,
prolonged exposure therapy, or eye movement desensitization and reprocessing) and may include
medication (such as selective serotonin reuptake inhibitors) to alleviate symptoms and improve
functioning.
2. Acute Stress Disorder:
- Acute stress disorder is similar to PTSD but occurs within one month following exposure to a
traumatic event and lasts for a minimum of three days and a maximum of four weeks.
- Symptoms of acute stress disorder include intrusive memories, dissociative reactions (such as
feeling detached from one's surroundings), negative mood, avoidance of trauma reminders, and
arousal symptoms (such as hypervigilance or exaggerated startle response).
- While acute stress disorder may resolve on its own, it can also increase the risk of developing
PTSD if symptoms persist beyond the acute phase.
- Treatment for acute stress disorder may involve psychoeducation, supportive counseling, and
trauma-focused interventions to prevent the development of chronic PTSD.

3. Adjustment Disorders:
- Adjustment disorders are characterized by the development of emotional or behavioral
symptoms in response to a stressful life event or change.
- The symptoms of adjustment disorders typically occur within three months of the onset of the
stressor and are out of proportion to the severity of the stressor.
- Common stressors that may trigger adjustment disorders include relationship problems, work
or academic stress, financial difficulties, relocation, or health concerns.
- Symptoms of adjustment disorders may include depressed mood, anxiety, irritability, conduct
disturbances, or a combination of these symptoms.
- Treatment for adjustment disorders often involves supportive counseling, problem-solving
techniques, stress management strategies, and, in some cases, medication to alleviate symptoms.

4. Other Specified and Unspecified Trauma- and Stressor-Related Disorders:

- In addition to the specific disorders mentioned above, the Diagnostic and Statistical Manual
of Mental Disorders (DSM-5) includes categories for other specified and unspecified trauma-
and stressor-related disorders.
- These categories are used when symptoms do not fully meet the criteria for a specific disorder
but still cause distress or impairment.
- Examples include adjustment-like disorders with prolonged duration of symptoms, brief
reactive psychosis, and other specified trauma- and stressor-related disorder with mixed
symptoms.
 - Treatment for these disorders is individualized based on the specific symptoms and needs of
the individual, often involving a combination of psychotherapy, medication, and supportive
interventions.

6) SOMATIC SYMPTOM DISORDERS

Somatic symptom disorders (SSD) are a group of psychological disorders characterized by
prominent physical symptoms that are distressing or result in significant disruption of daily life,
yet cannot be fully explained by a medical condition.
- The key feature of somatic symptom disorders is the presence of one or more distressing
physical symptoms that lead to excessive thoughts, feelings, or behaviors related to the
symptoms.
- These symptoms may or may not be associated with diagnosed medical conditions, but they
cause significant distress or impairment in social, occupational, or other areas of functioning.
- The symptoms are not intentionally produced or feigned (as in factitious disorder or
malingering) and are not better explained by another mental disorder.

1. Types of Somatic Symptom Disorders:

- The DSM-5 identifies several specific somatic symptom disorders, including somatic
symptom disorder, illness anxiety disorder (formerly hypochondriasis), conversion disorder
(functional neurological symptom disorder), and factitious disorder.
- Somatic symptom disorder is characterized by one or more distressing somatic symptoms
accompanied by excessive thoughts, feelings, or behaviors related to the symptoms, lasting for at
least six months.
- Illness anxiety disorder involves excessive worry about having a serious illness despite
minimal or no physical symptoms, leading to frequent health-related visits or excessive health-
related behaviors (such as checking for symptoms or seeking reassurance).
- Conversion disorder (functional neurological symptom disorder) involves neurological
symptoms (such as weakness or paralysis, tremors, or seizures) that cannot be explained by a
medical condition or by neurological or other medical factors, often associated with significant
distress or impairment.
- Factitious disorder involves intentionally producing or feigning physical or psychological
symptoms to assume the sick role or to gain attention, sympathy, or care from others.
2. Treatment Approaches:
- Treatment for somatic symptom disorders often involves a multimodal approach addressing
both the physical and psychological aspects of the symptoms.
- Psychoeducation is an essential component of treatment, helping individuals understand the
relationship between stress, emotions, and physical symptoms.
- Cognitive-behavioral therapy (CBT) is a widely used and effective psychotherapeutic
approach for somatic symptom disorders, focusing on identifying and challenging maladaptive
thoughts and behaviors related to physical symptoms.
- Medication may be prescribed to alleviate symptoms of anxiety or depression associated with
somatic symptom disorders, but it is typically used as an adjunct to psychotherapy rather than as
a standalone treatment.
- Collaborative care models involving primary care providers, mental health professionals, and
specialists (such as neurologists or gastroenterologists) can help coordinate comprehensive care
for individuals with somatic symptom disorders.

7) DISSOCIATIVE DISORDERS
Dissociative disorders are a group of mental health conditions characterized by disruptions or
discontinuities in an individual's consciousness, memory, identity, or perception of the
environment. These disorders typically develop as a response to severe trauma, stress, or
overwhelming experiences.
- The key feature of dissociative disorders is the presence of disruptions in consciousness,
memory, identity, or perception that are not consistent with ordinary forgetting.
- Symptoms may include dissociative amnesia (inability to recall important personal
information), depersonalization (feeling detached from oneself or one's body), derealization
(feeling detached from the surrounding environment), identity disturbance (alterations in identity
or sense of self), and other dissociative symptoms.

1. Types of Dissociative Disorders:

- The DSM-5 identifies several specific dissociative disorders, including dissociative amnesia,
dissociative identity disorder (DID), depersonalization/derealization disorder, other specified
dissociative disorder, and unspecified dissociative disorder.
- Dissociative amnesia involves an inability to recall important personal information, usually
related to traumatic or stressful events, that is not due to ordinary forgetting or neurological
conditions.
 - DID, formerly known as multiple personality disorder, involves the presence of two or more
distinct personality states or identities within the same individual, accompanied by recurrent
episodes of amnesia and other dissociative symptoms.
- Depersonalization/derealization disorder involves persistent or recurrent experiences of
depersonalization (feeling detached from oneself or one's body) or derealization (feeling
detached from the surrounding environment), causing significant distress or impairment.
- Other specified and unspecified dissociative disorders are used when symptoms do not fully
meet the criteria for a specific disorder but still cause distress or impairment.

2. Treatment Approaches:
- Treatment for dissociative disorders often involves a multimodal approach addressing both
the dissociative symptoms and underlying trauma or stressors.
- Psychotherapy is the cornerstone of treatment for dissociative disorders, with approaches
such as trauma-focused therapy, cognitive-behavioral therapy (CBT), dialectical behavior
therapy (DBT), and eye movement desensitization and reprocessing (EMDR) being commonly
used.
- Medication may be prescribed to alleviate symptoms of comorbid conditions (such as
depression, anxiety, or sleep disturbances) associated with dissociative disorders, but it is
typically used as an adjunct to psychotherapy rather than as a standalone treatment.
- Supportive interventions, including psychoeducation, safety planning, grounding techniques,
and emotion regulation skills, are essential for promoting stabilization and coping skills in
individuals with dissociative disorders.

8)SUBSTANCE RELATED DISORDES AND ADDITIVE DISORDERS

Substance-related and addictive disorders encompass conditions involving the misuse of drugs,
alcohol, and other substances, as well as certain behaviors, leading to significant impairment or
distress. These disorders are characterized by the inability to control substance use or
engagement in addictive behaviors, despite harmful consequences.

1. Definition and Classification

- Substance-Related Disorders: Disorders involving the use of drugs, alcohol, or other
substances. These include:
- Substance Use Disorders (SUDs): Chronic, relapsing conditions marked by compulsive
substance use despite adverse consequences.
- Substance-Induced Disorders: Conditions including intoxication, withdrawal, and
substance/medication-induced mental disorders (e.g., depression, anxiety, psychosis).
- Addictive Disorders: Involve engagement in behaviors that are rewarding but harmful when
performed compulsively. The primary example in DSM-5 is Gambling Disorder.

2. Types of Substances Involved

- Alcohol: Leads to alcohol use disorder, characterized by dependence, withdrawal, and various
health problems.
- Cannabis: Cannabis use disorder, marked by cognitive impairment and psychological effects.
- Opioids: Opioid use disorder, involving painkillers and heroin, with risks of overdose and
severe withdrawal.
- Stimulants: Stimulant use disorder, related to cocaine, methamphetamine, and prescription
stimulants.
- Sedatives, Hypnotics, and Anxiolytics: Includes benzodiazepines, leading to dependence and
withdrawal.
- Tobacco: Tobacco use disorder, associated with significant health risks such as cancer and
cardiovascular diseases.
- Hallucinogens: Include substances like LSD and psilocybin, potentially causing persistent
psychosis or perceptual disturbances.

3. Behavioral Addictions
- Gambling Disorder: The only behavioral addiction officially recognized in DSM-5. It involves
persistent and problematic gambling behavior leading to significant impairment or distress.
- Other Potential Behavioral Addictions: Although not formally recognized in DSM-5, activities
like internet use, gaming, shopping, and sex can develop addictive patterns similar to substance
use disorders.

4. Treatment Approaches
- Behavioral Therapies: Include cognitive-behavioral therapy (CBT), motivational interviewing
(MI), and contingency management. These therapies aim to modify maladaptive behaviors,
enhance motivation for change, and reinforce positive behaviors.
- Medications:
- Alcohol Use Disorder: Medications like naltrexone, acamprosate, and disulfiram help reduce
cravings and maintain abstinence.
- Opioid Use Disorder: Medications such as methadone, buprenorphine, and naltrexone help
manage withdrawal and reduce relapse.
- Tobacco Use Disorder: Nicotine replacement therapies, bupropion, and varenicline aid in
smoking cessation.
- Support Groups: Programs like Alcoholics Anonymous (AA) and Narcotics Anonymous (NA)
provide peer support and a structured recovery environment.
- Integrated Treatment: Combines medical, psychological, and social interventions to address
all aspects of the disorder, particularly for individuals with co-occurring mental health
conditions.