CH-4: PSYCHOLOGICAL DISORDERS

Concepts of Abnormality and Psychological Disorders

Psychological disorders are: (Four D’s)

a. Deviant (different, extreme, unusual, bizarre)

b. Distressing (unpleasant and upsetting to the person and to others)
c. Dysfunctional (interfering with the person’s ability to carry out daily
activities in a constructive way)
d. Dangerous (to the person or to others).

‘Abnormal’ literally means “away from the normal”, it implies deviation

from some clearly defined norms or standards.

Approaches to distinguish between normal and abnormal behavior:

The first approach views abnormal behavior as a deviation from

social norms.

 According to this approach, ‘Abnormal’ is simply a label that is given

to a behavior which is deviant from social expectations.
 Abnormal behavior, thoughts and emotions are those that differ
markedly from a society’s ideas of proper functioning.
 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 population culture - its history,
values, institutions, habits, skills, arts and technology.
 A society’s values may change over time, causing its view of what is
psychologically abnormal to change as well.
 Socially accepted behavior is not abnormal, and normality is nothing
more than conformity to social norms.

The second approach views abnormal behavior as maladaptive.

 According to this approach, the best criterion for determining the

normality of behavior is not whether the society accepts it but
whether it fosters the well-being of the individual and eventually of
the group to which he/she belongs.
 Well-being is simply not maintenance and survival but also includes
growth and fulfilment i.e. the actualization of potential.
 Conforming behavior can be seen as abnormal if it is maladaptive,
i.e. if it interferes with optimal functioning and growth.
  Describing behavior as maladaptive implies that a problem exists; it
also suggests that vulnerability in the individual, inability to cope, or
exceptional stress in the environment have led to problems in life.

Historical Background

Supernatural Approach

 Abnormal behavior can be explained by the operation of

supernatural and magical forces such as evil spirits or the devil.
 Exorcism i.e. removing the evil that resides in the individual through
countermagic and prayer, is still commonly used.
 In many societies, the shaman, or medicine man (ojha) is a person
who is believed to have a contact with supernatural forces and is
the medium through which spirits communicate with human beings.
Through the shaman, and afflicted person can learn which spirts are
responsible for his/her problems and what needs to be done to
appease them.

1. Biological or Organic Approach

 Individuals behave strangely because their bodies and their brains
are not working properly is another belief in the history of abnormal
psychology.
 Body and brain processes have been linked to many types of
maladaptive behaviors.
 For certain types of disorders, correcting these defective biological
processes results in improved functioning.

Psychological Approach

 According to this, psychological problems are caused by

inadequacies in the way an individual thinks, feels or perceives the
world.
Organismic Approach

 Hippocrates, Socrates and in particular Plato (philosopher-physicians

of ancient Greece) viewed disturbed behavior as arising out of
conflicts between emotion and reason.
Based on Four Humours

 Galen elaborated on the role of four humors in personal character

and temperament.
 According to him, the material world was made up of four elements
(earth, air, fire and water) which combine to form four essential
body fluids (blood, black bile, yellow bile and phlegm).
  Each of these fluids was seen to be responsible for a different
temperament.
 Imbalances among the humours were believed to cause various
disorders.

In Middle Ages

 Demonology and superstition gained renewed importance in the

explanation of abnormal behavior.
 Demonology related to a belief that people with mental problems
were evil and there are numerous instances of ‘witch-hunt’ during
this period.
 During the early Middle Ages, the Christian spirit of charity prevailed
and St. Augustine wrote extensively about feelings, mental anguish
and conflict.
 This laid the groundwork for modern psychodynamic theories of
abnormal behavior.

Renaissance Period

 This period was marked by increased humanism and curiosity about

behavior.
 Johann Weyer emphasized psychological conflict and disturbed
interpersonal relationships as causes of psychological disorders.
 He also insisted that ‘witches’ were mentally disturbed and required
medical, not theological, treatment.

Age of Reason and Enlightenment (17th & 18thcentury)

 The scientific method replaced faith and dogma as ways of

understanding abnormal behavior.
 The growth of a scientific attitude towards psychological disorders in
the 18th century contributed to the Reform Movement and to
increased compassion for people who suffered from these
disorders.
 Reforms of asylums were initiated both in Europe and America.
 One aspect of the reform movement was the new inclination for
deinstitutionalization which placed emphasis on providing
community care for recovered mentally ill individuals.

Interactional or Bio-Psycho-Social Approach

 From this perspective, all three factors (biological, psychological and

social) play important role in influencing the expression and
outcome of psychological disorders.
Classification Of Psychological Disorders

 A classification of psychological disorders consists of a list of

categories of specific psychological disorders grouped into various
classes on the basis of some shared characteristics.
 Classifications are useful because they enable users like
psychologists, psychiatrists and social workers to:

a. Communicate with each other about the disorder

b. Help in understanding the causes of psychological disorders and the
processes involved in their development and maintenance

 Official manuals describing and classifying various kinds of

psychological disorders:

1) Diagnostic and Statistical Manual of Mental Disorders 5 th Edition

(DSM-5): Current

by the American Psychiatric Association (APA)

It presents discrete clinical criteria which indicate the presence or absence

of disorders.

2) International Classifications of Diseases (ICD-10)

ICD-10 Classification of Behavioral and Mental Disorders by WHO

(World Health Organizations)

For each disorder, a description of the main clinical features or symptoms,

and of other associated features including diagnostic guidelines is
provided.

Factors Underlying Abnormal Behavior

Biological Factors influence all aspects of our behavior.

 A wide range of biological factors may interfere with normal

development and functioning of the human body such as:
i. Faulty genes
ii. Endocrine imbalances
iii. Malnutrition
iv. Injuries
 These factors may be potential causes of abnormal behavior.
 According to the biological model, abnormal behavior has a
biochemical or physiological basis.
 Psychological disorders are often related to problems in the
transmission of messages from one neuron to another across
synapse.
 When an electrical impulse reaches a neuron’s ending, the nerve
ending is stimulated to release a chemical called neuro-transmitter.
 Abnormal activity by certain neuro-transmitters can lead to specific
psychological disorders. For example,
i. Anxiety disorders have been linked to low activity of
neurotransmitter - gamma aminobutyric acid (GABA)
ii. Schizophrenia to excess activity of dopamine.
iii. Depression to low activity of serotonin
.
Genetic Factors

They have been linked to mood disorders, schizophrenia, mental


retardation and other psychological disorders such as depression,
anxiety, etc.
 In most cases, no single gene is responsible for a particular
behaviour or a psychological disorder. In fact, many genes combine
to help bring about our various behaviours and emotional reactions,
both functional and dysfunctional.
Psychological Model

This model also provides a psychological explanation of mental


disorders.
 These models maintain that psychological and interpersonal factors
have a significant role to play in abnormal behavior.
 These factors include:
(a) Maternal deprivation

i. Separation from the mother

ii. Lack of warmth and stimulation during early years of life.
(b) Faulty parent-child relationships

i. Rejection
ii. Overprotection
iii. Over-permissiveness
iv. Faulty discipline
(c) Maladaptive family structures

i. Inadequate or disturbed family

(d) Severe stress

Psychodynamic Model (oldest and most famous of the modern

psychological models)

 Theorists believe that behaviour, whether normal or abnormal, is

determined by psychological forces within the person of which
she/he is not consciously aware.
 These internal forces are considered dynamic i.e. they interact with
one another and their interaction gives shape to behaviours,
thoughts and emotions.
 Abnormal symptoms are viewed as the result of conflicts between
these forces.
 Freud believed that 3 central forces shape personality:
i. Instinctual needs, drives and impulses (id)
ii. Rational thinking (ego)
iii. Moral standards (super ego)
 He stated that abnormal behavior is a symbolic expression of
unconscious mental conflicts that can be generally traced to early
childhood or infancy.

Behavioral Model

 It states that both normal and abnormal behaviors are learned and
psychological disorders are the result of learning maladaptive ways
of behaving.
 It concentrates on behaviors that are learned through conditioning
and propose that what has been learned can be unlearned.
 Learning can take place by:
i. Classical conditioning (temporal association in which two events
repeatedly occur close together in time)
ii. Operant conditioning (behavior is followed by a reward)
iii. Social learning (learning by imitating others’ behavior)
 These 3 types of conditioning account for behavior, whether
adaptive or maladaptive.

Cognitive Model

 It states that abnormal functioning can result from cognitive

problems.
 People may hold assumptions and attitudes about themselves that
are irrational and inaccurate.
 People may also think repeatedly in illogical ways and make
overgeneralizations i.e. they may draw broad, negative conclusions
on the basis of a single insignificant event.

Humanistic-Existential Model

 Focuses on broader aspects of human existence.

 Humanists believe that human beings are born with a natural
tendency to be:
i. Friendly
ii. Cooperative
iii. Constructive
iv. Are driven to self-actualize i.e. to fulfill this potential for goodness
and growth
 Existentialists believe that from birth we have total freedom to
give meaning to our existence or to avoid that responsibility
 Those who shrink from this responsibility would like
i. Empty
ii. Inauthentic and
iii. Dysfunctional lives

Socio-Cultural Model
  Socio cultural factors such as:
i. War and violence
ii. Group prejudice and discrimination
iii. Economic and employment problems
iv. Rapid social change
put stress on most of us and can also lead to psychological problems in
some individuals.

 According to this model, abnormal behavior is best understood in

light of the social and cultural forces that influence an individual.
 As behavior is shaped by societal forces, following factors become
more important:
a) Family structure and communication

Certain family systems are likely to produce abnormal functioning in

individual members.

Some families have an enmeshed structure in which the members are

overinvolved in each other’s activities, thoughts and feelings. Children
from this kind of family may have difficulty in becoming independent in
life.

b) Social networks

The broader social networks in which people operate include their social
and professional relationships.

People who are isolated and lack social support, i.e., strong and fulfilling
interpersonal relationships in their lives are likely to become more
depressed and remain depressed longer than those who have good
friendships.

c) Societal labels and roles

Abnormal functioning is influenced by the societal labels and roles

assigned to troubled people. When people break the norms of their
society, they are called deviant and ‘Mentally ill’.

 Such labels tend to stick so that the person may be viewed as

‘crazy’ and encouraged to act sick. The person gradually learns to
accept and play the sick role, and functions in a disturbed manner.

Diathesis - Stress Model (widely accepted)

  It states that psychological disorders develop when a diathesis
(biological predisposition to the disorder) is set off by a stressful
situation.
 This model has 3 components:
i. The first is the diathesis or the presence of some biological
aberration which may be inherited.
ii. The second 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.
iii. The third 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.

Major Psychological Disorders

1) Anxiety Disorders

 High levels of anxiety that are distressing and interfering with

effective functioning indicate the presence of an anxiety disorder.
 The term 'anxiety' is usually defined as a diffuse, vague, very
unpleasant feeling of fear and apprehension.
 The anxious individual shows combinations of the following
symptoms:
a. Rapid heart rate
b. Shortness of breath
c. Diarrhea
d. Loss of appetite
e. Fainting
f. Dizziness
g. Sweating
h. Sleeplessness
a. Frequent urination
j. Tremors

a) Generalized Anxiety Disorder

 Consists of prolonged, vague, unexplained and intense fears that

are not attached to any particular object.
 Symptoms:
a. Worry and apprehensive feelings about the future
b. Hypervigilance (involves constantly scanning the environment for
dangers)
c. Motor tension, as a result of which the person is unable to relax, is
restless and visibly shaky and tense.
b) Panic Disorder

 Consists of recurrent/frequent anxiety attacks in which the person

experiences intense terror and dread.
 A panic attack denotes an abrupt surge of intense anxiety rising to a
peak when thoughts of a particular stimuli are present.
 Such thoughts occur in an unpredictable manner.
 Clinical features:
a. Shortness of breath
b. Dizziness
c. Chest pain or discomfort
d. Palpitations
e. Fear of going crazy
f. Nausea
g. Choking
h. Losing control
a. Dying
j. Trembling

c) Phobias

a. Irrational fears related to specific objects, people or situations.

e. They develop gradually or begin with a generalized anxiety disorder.
e. Phobias can be grouped into three main types, i.e. specific phobias,
social phobias, and agoraphobia.
(i) Specific Phobias

 Most commonly occurring type of phobia

 Irrational fears such as:
a. Intense fear of a certain type of animal
b. Being in an enclosed space.
(ii) Social Phobias

 Intense and incapacitating fear and embarrassment when dealing

with others.
 Also known as Social Anxiety Disorder
(iii) Agoraphobia

 When people develop a fear of entering unfamiliar situations

 Many agoraphobics are:
a. Afraid of leaving their home
b. Unable to carry out normal life activities

d) Separation Anxiety Disorders

  Individuals are fearful and anxious about separation from
attachment figures to an extent that is developmentally not
appropriate.
 Extreme distress when expecting or going through separation from
home or other significant people to whom the individual is
immensely attached to.
 Children with SAD may have difficulty:
a. Being in a room by themselves
b. Going to school alone
c. Are fearful of entering new situations
d. Cling to and shadow their parents’ every move
 To avoid separation, children with SAD may:
a. Fuss
b. Scream
c. Throw severe tantrums
d. Make suicidal gestures
e) Other disorders are:

 Selective Mutism
 Substance/Medication Induced Anxiety Disorder
 Anxiety Disorder due to another medical condition
2) Obsessive - Compulsive and Related Disorders

a) Obsessive - Compulsive Disorder (OCD)

 People affected by OCD are unable to control their preoccupation

with specific ideas.
 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 behavior is the inability to stop thinking about a
particular idea or topic which the person involved often finds to be
unpleasant and shameful.
 Compulsive behavior is the need to perform certain behaviors over
and over again.
 Example- counting, ordering, checking, touching, washing.
b) Other disorders are:

 Hoarding disorder
 Trichotillomania (hair-pulling disorder)
 Excoriation (skin-picking disorder)
3) Trauma and stressor related disorders

a) Post-traumatic stress disorder (PTSD)

 People who experience PTSD are often the ones:

 a. Caught in a natural disaster
b. Have been victims of bomb blasts by terrorists
c. Been in a serious accident
d. Been in a war-related situation
 Symptoms vary widely but may include:
a. Recurrent dreams
b. Flashbacks
c. Impaired concentration
d. Emotional numbing
b) Other disorders are:

 Adjustment disorders
 Acute stress disorder
4) Somatic Symptom and Related Disorders

 People experience physical symptoms in the absence of a physical

disease.
 The individual has psychological difficulties and complains of
physical symptoms, for which there is no biological cause.
a) Somatic Symptom Disorder (presence of physical complaints)

 involves a person having persistent body-related symptoms which

may or may not be related to any serious medical condition.
 People with this order tend to be overly preoccupied with their
symptoms.
 Continually worry about their health.
 Make frequent visits to doctor
 As a result, they experience significant distress and disturbances in
their daily life.
b) Illness Anxiety Disorder (presence of anxiety)

 Involves persistent preoccupation about developing a serious illness

and constantly worrying about their possibility
 Accompanied by anxiety about one’s health.
 People with this disorder are overly concerned about undiagnosed
disease and negative diagnostic results.
 Do not respond to assurance by doctors
 Are easily alarmed about illness such as on hearing about someone
else’s ill-health or some such news.
c) Conversion Disorders

 The symptoms of conversion disorders are the reported loss of part

or all of some basic body functions for example:
a. Paralysis
b. Blindness
c. Deafness
 d. Difficulty in walking
 These symptoms often occur after a stressful experience and may
be quite sudden, and have no physical cause.
5) Dissociative Disorders

 Dissociation can be viewed as severance of the connections

between ideas and emotions.
 It involves feelings of:
a. Unreality
b. Depersonalisation
c. Estrangement
d. Sometimes a loss or shift of identity
 Characteristic:
a. Sudden temporary alterations of consciousness that blot out painful
experiences.
a) Dissociative Amnesia

 Extensive but selective memory loss that has no known organic

cause (example- 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 remain intact.
 A part of dissociative amnesia is dissociative fugue.
 Essential features of dissociative fugue are:
a. Unexpected travel away from home and workplace
b. Assumption of a new identity
c. 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.
b) Dissociative Identity Disorder (referred to as ‘multiple
personality’)

 Most dramatic
 Often associated with traumatic experiences in childhood
 The person assumes alternate personalities that may or may not be
aware of each other
c) Depersonalization/Derealization Disorder

 Involves a dream-like state in which the person has a sense of being

separated both from self and from reality
 In depersonalization, there is a change of self-perception and the
person’s sense of reality is temporarily lost or changed.
6) Depressive Disorders
  Depression is one of the most widely prevalent and recognized of all
mental disorders.
 It covers a variety of negative mood and behavioral changes.
 It can be referred to as a symptom as well as a disorder.
a) Major Depressive Disorder

(i) A period of:

a. Depressed mood
b. Loss of interest or pleasure in most activities
c. Change in body weight
d. Constant sleep problems
e. Tiredness
f. Inability to think clearly
g. Agitation
h. Greatly slowed behavior
a. Thoughts of death and suicide
j. Excessive guilt
k. Feelings of worthlessness
(ii) Factors predisposing towards depression (Risk factors):

a. Genetic make-up/ heredity

b. Age
 Women during young adulthood
 Men during early middle age
c. Gender
 Women are more likely to report a depressive disorder
d. Negative life event
e. Lack of social support
7) Bipolar And Related Disorders

a) Bipolar I Disorder (earlier referred to as ‘Manic- depressive

disorders’)

 Involves mania and depression, which are alternatively present and

sometimes interrupted by periods of normal mood.
 Manic episodes rarely appear by themselves; they usually alternate
with depression.
b) Other disorders are:

 Bipolar II disorder
 Cyclothymic disorder
Suicide

 Can take place at any point of time of life

 Result of complex interface of biological, genetic, psychological,
sociological, cultural and environmental factors.
 Risk factors are:
a. Having mental disorders (especially depression and alcohol use
disorders)
b. Going through natural disasters
c. Experiencing violence, abuse or loss
d. Isolation at any stage of life
e. Previous suicidal attempt (Strongest risk factor)
 Suicidal behavior often indicates difficulties in:
a. Problem-solving
b. Stress management
c. 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
 The ramifications of suicide on social circle and communities tend to
be devasting and long-lasting.
 The stigma surrounding suicide compel many people, who are
contemplating or even attempting suicide, to not seek help thus,
preventing timely help from reaching them.
 Therefore, improving identification, referral and management of
behavior are crucial for preventing suicide.
 Therefore, we need to:
a. Identify the vulnerability
b. Comprehend the circumstances leading to such behavior
c. Accordingly plan interventions
 Suicides are preventable but there is a need for comprehensive
multi-sectoral approach where the government, media and civil
society all play important role as stake holders.
 Measures suggested by WHO for preventing suicides are:
a. Limiting access to the means of suicide.
b. Reporting of suicide by media in a responsible way
c. Bringing in alcohol related policies
d. Early identification, treatment and care of people at risk
e. Training health workers in assessing and managing for suicide
f. Care for people who attempted suicide and providing community
support.
Identifying Students In Distress

 Any unexpected or striking change affecting the adolescent’s

performance, attendance or behavior should be taken seriously,
such as:
a. Lack of interest in common activities
b. Declining grades
c. Decreasing effort
d. Misbehavior in the classroom
e. Mysterious or repeated absence
 f. Smoking or drinking, or drug misuse.
Strengthening Students’ Self Esteem

 Having a positive self-esteem is important in face of distress and

helps in coping adequately.
 In order to foster positive self-esteem in children the following
approaches can be useful:
a. Accentuating positive life experiences to develop positive identity
leading to increased confidence in self.
b. Providing opportunities for development of physical, social and
vocational skills
c. Establishing a trustful communication
d. Goals for the students should be specific, measurable, achievable,
relevant, to be completed within a relevant time frame.
8) Schizophrenia Spectrum and Other Psychotic Disorders

 Schizophrenia is a descriptive term for 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.
 Debilitating disorder
 The social and psychological costs of schizophrenia are tremendous,
both to patients as well as to their families and society.
 Symptoms of schizophrenia:
a) Positive symptoms (i.e., excesses of thought, emotion and behavior)

‘Pathological excesses’ or ‘bizarre additions’ to a person’s behavior

Delusions

 A delusion is a false belief that is firmly held on inadequate grounds.

 It is not affected by rational argument.
 It has no basis in reality
Disorganized thinking and speech/ Formal thought disorders

 May not be able to think logically

 May speak in peculiar ways
 Make communication extremely difficult
 Includes:
Heightened perception and Hallucinations

 They are perceptions that occur in the absence of external stimulus.

Inappropriate affect i.e. emotions that are unsuited to the

situation
b) Negative symptoms (i.e. deficits of thought, emotion and
behavior)

‘Pathological Deficits’

Alogia or Poverty of speech

 Reduction in speech and speech content

Blunted Affect

 Show less anger, sadness, joy and other feelings than most people
do
Flat Affect

 Some show no emotions at all

Avolition/ Apathy (lack of interest, enthusiasm or concern)
  Inability to start or complete a course of action
Social Withdrawal

 May withdraw socially and become tally focused on their own ideas
and fantasies
Psychomotor Symptoms

 move less spontaneously

 make odd grimaces and gestures
 may take extreme forms known as catatonia
i. People in a catatonic stupor remain motionless and silent for long
stretches of time.
ii. Catatonic rigidity i.e., mainting a rigid, up bright posture for hours.
iii. Catatonic posturing i.e., assuming awkward, bizarre positions for
long periods of time.
9) Neurodevelopmental Disorders

 Common feature - they manifest in the early stage of development

 The symptoms often appear before the child enters school or during
the early stage of schooling
 These disorders result in:
a. Hampering personal, social, academic and occupational functioning.
 Characteristics:
a. Deficits or excesses in a particular behavior
b. Delays in achieving a particular age-appropriate behavior
10) Attention Deficit/Hyperactivity Disorder (ADHD)

 If not attended, can lead to more serious and chronic disorders as

the child moves into adulthood.
 Main features are:
a) Inattention

 Children find it difficult to sustain mental effort during work or play.

 Have a hard time keeping their minds on any one thing
 Have a hard time in following instructions:
 Common complaints are:
1. Child does not listen
2. Cannot concentrate
3. Does not follow instructions
4. Is disorganized
5. Easily distracted
6. Forgetful
7. Does not finish assignments
8. Quick to lose interest in boring activities
b) Impulsivity
  Children seem unable to control their immediate reactions
 Unable to think before they act
 Find it difficult to wait or take turns
 Have difficulty resisting immediate temptations or delaying
gratification
 Minor mishaps such as knocking things over are common, whereas
more serious accidents and injuries can also occur.
c) Hyperactivity

 Children are in constant motion

 Sitting still through a lesson is impossible for them
 Child may fidget, squirm, climb and run around the room aimlessly
 Parents and teachers describe them as ‘driven by a motto’, always
on the go, and talk incessantly.
11) Autism Spectrum Disorder (ASD)

 If not attended, can lead to more serious and chronic disorders as

the child moves into adulthood.
 Characteristics:
a. Widespread impairments in social interaction and communication
skills.
b. Stereotyped patterns of behaviors, interests and activities.
 Children with ASD have:
a. Marked difficulties in social interaction and communication across
different contexts
b. A restricted range of interests
c. Strong desire for routine
 About 70% of children with ASD have intellectual disabilities.
 Children with ASD:
a. Experience profound difficulties in relating to other people.
b. Are unable to initiate social behavior
c. Seem unresponsive to other people’s feelings
d. Unable to share experiences or emotions with others
e. Show serious abnormalities in communication and language that
persist over time
f. Many of them never develop speech and those who do, have
repetitive and deviant speech patterns
g. Show narrow patterns of interests
h. Show repetitive behaviors such as lining up objects or stereotyped
body movements such as rocking.
i. These motor movements may be:
 Self-stimulatory such as hand flapping
 Self-injurious such as banging their heads against the wall.
j. Tend to experience difficulties in starting, maintaining and even
understanding relationships due to the difficulties in terms of verbal
and non-verbal communications.
12) Intellectual Disability
  Refers to below average intellectual functioning (with an IQ of
approx 70 or below)
 Deficits or impairments in adaptive behaviors (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.
 If not attended, can lead to more serious and chronic disorders as
the child moves into adulthood.

13) Specific Learning Disorder

 Individual experiences difficulty in perceiving or processing

information efficiently and accurately.
 These get manifested during early school years.
 The individual encounters problems in basic skills in reading, writing
and mathematics.
 Tends to perform below average for his/her age.
 However, with additional inputs and efforts the individuals may be
able to reach acceptable performance levels.
 Likely to impair functioning and performance in
activities/occupations dependent on the related skills.
 If not attended, can lead to serious and chronic disorders as the
child moves into adulthood.
14) Disruptive, Impulse-Control and Conduct Disorders

a) Oppositional Defiant Disorder (ODD)

v. Children display age-inappropriate amounts of stubbornness

v. Are irritable, defiant, disobedient
v. Behave in a hostile manner
v. Do not see themselves as angry, oppositional or defiant and often
justify their behavior as reaction to circumstances/demands.
v. The symptoms of the disorder become entangled with problematic
interactions with others.
b) Conduct Disorder/Antisocial Behaviour

 Refers to age-inappropriate actions and attitudes that violate family

expectations, societal norms and personal or property right of
others.
 Behaviors typical of conduct disorder include:
i. Aggressive actions that cause or threaten harm to people or animals
ii. Non-aggressive conduct that causes property damage
iii. Major deceitfulness or theft
iv. Serious rule violations
 Children show many different types of aggressive behavior such as:
i. Verbal aggression (i.e., name-calling, swearing)
ii. Physical aggression (i.e., hitting, fighting)
iii. Hostile aggression (i.e., directed at inflicting injury to others)
iv. Proactive aggression (i.e., dominating and bullying others without
provocation)
15) Feeding And Eating Disorders

a) Anorexia Nervosa

The individual has a distorted body image that leads her/him to see

herself/himself as overweight.
 Often refuses to eat
 Exercises compulsively
 Developing unusual habits such as refusing to eat in front of others
 Person may lose large amounts of weight and even starve
her/himself to death.
b) Bulimia Nervosa

The individual may eat excessive amounts of food, then purge


her/his body of food by using medicines such as laxatives or
diuretics or by vomiting.
 The person often feels disgusted and ashamed when she/he binges
and is relieved of tension and negative emotions after purging.
c) Binge Eating
  Frequent episodes of out-of-control eating.
 The individual tends to eat at a higher speed than normal and
continues eating till she/he feels uncomfortably full.
 Large amount of food may be eaten even when the person is not
feeling hungry.
16) Substance-Related And Addictive Disorders

 Related to maladaptive behaviors resulting from regular and

consistent use of the substance involved.
 Includes problems associated with the use and abuse of alcohol,
cocaine, tobacco and opiods among others, which alter the way
people think, feel and behave.
 Frequently used substances are:
1) Alcohol

 People who abuse alcohol, drink large amounts regularly and rely on
it to help them face difficult situations.
 Eventually, the drinking interferes with their social behavior and
ability to think and work.
 Their bodies build up to a tolerance for alcohol and they need to
drink even greater amounts to feel its effects.
 They also experience withdrawal responses when they stop
drinking.
 Alcoholism destroys:
 Millions of families
 Social relationships
 Careers
 Intoxicated drivers are responsible for many road accidents.
 Has serious effects on the children of persons with this disorder as
they have higher rates of psychological problems
a) Anxiety

b) Depression

c) Phobias

d) Substance-related disorders

 Excessive drinking can seriously damage physical health.

2) Heroin

 Its intake significantly interferes with social and occupational

functioning.
  Most abusers further develop a dependence on heroin, revolving
their lives around the substances, building up a tolerance for it and
experiencing a withdrawal reaction when they stop taking it.
 Most direct danger of heroin abuse is an overdose, which slows
down the respiratory centres in the brain, almost paralyzing
breathing, and in many cases causing death.
3) Cocaine

 Regular use of cocaine may lead to a pattern of abuse in which the

person may be intoxicated throughout the day and function poorly
in social relationships and at work.
 May also cause problems in short-term memory and attention.
 Dependence may develop, so that cocaine dominates the person’s
life, more of the drug is needed to get the desired effects, and
stopping it results in feeling of
a) Depression

b) Sleep problems

c) Anxiety

d) Fatigue

e) Irritability

 Cocaine poses serious dangers as it has dangerous effects on

psychological functioning and physical well-being.