Chapter 14
psychological disorders
psychology
                       fourth edition
 Psychology, Fourth Edition                        Copyright ©2015, 2012, 2008 by Pearson Education, Inc.
 Saundra K. Ciccarelli • J. Noland White                                              All rights reserved.
Early Explanations of Mental Illness
• In ancient times holes were cut in an ill person’s
  head to let out evil spirits in a process called
  trephining
• Hippocrates believed that mental illness came
  from an imbalance in the body’s four humors
  – phlegm, black bile, blood, and yellow bile
• In the Middle Ages, the mentally ill were labeled
  as witches
       Definitions of Abnormality
• Psychopathology: the study of abnormal
  behavior
• Abnormal behaviors may be
  – statistically rare
  – deviant from social norms
  – That is to say: they have statistical or
    social norm deviance
    Definitions of Abnormality
• Situational context: the social or
  environmental setting of a person’s
  behavior.
  – Abnormality may produce subjective
    discomfort: emotional distress or discomfort
  – maladaptive thinking or behavior: anything
    that does not allow a person to function within
    or adapt to the stresses and everyday
    demands of life (Inability to function normally)
     Definitions of Abnormality
      Your Text’s Working definition:
• Psychological disorder: any pattern of
  behavior that causes people significant distress,
  causes them to harm themselves or others, or
  harms their ability to function in daily life
 Factors involved in Abnormality
Statistical or social norm deviance
         Situational context
       Subjective discomfort
   Inability to function normally
Psychological Viewpoints of Psychopathology
• Psychodynamic theorists: abnormal
  behavior stems from repressed conflicts
  and urges that are fighting to become
  conscious
• Behaviorists: abnormal behavior is learned
• Cognitive theorists: abnormal behavior
  comes from irrational beliefs and illogical
  patterns of thought
     Definitions of Abnormality
• Sociocultural perspective: abnormal behavior is
  the product of family, social, and cultural
  influences
  – cultural relativity: the need to consider the unique
    characteristics of the culture in which behavior takes
    place
  – culture-bound syndromes: disorders found only in
    particular cultures
  BIOPSYCHOSOCIAL MODEL
• Biopsychosocial model: incorporates biology,
  psychology, and culture into a single
  explanation of abnormal behavior
                           DSM-5
• Diagnostic and Statistical Manual, Fifth
  Edition, (DSM-5): manual of psychological
  disorders and their symptoms
• International Classification of Diseases
  (ICD): an international resource published
  by the World Health Organization (WHO)
  – currently in its tenth edition (ICD-10) see relevant
    links at rcgates.com
         Types of Disorders
• In a given year, about 26.2 percent of
  American adults over age 18 suffer from a
  mental disorder
  – only about 5.8 percent suffer from a severe
    mental disorder
  – It is common to suffer from more than one
    disorder at a time
             Labeling Disorders
• Pros
  – provide a common language to professionals
  – establish distinct categories of diagnosis for
    treatment and understanding
• Cons
  – overly prejudicial
  – “psychology student’s syndrome” There's a major
   issue with being a psych student, especially one who's taken abnormal
   psychology. There's a tendency called psychology student syndrome, also
   known as "generalized disorder disorder." It goes basically like this: You learn
   about a disorder, you suddenly recognized parts of yourself in it.
  Disorders of Anxiety, Trauma,
           and Stress
• Anxiety disorders: the main symptom is
  excessive or unrealistic worry and
  fearfulness
  – free-floating anxiety: anxiety that is unrelated
    to any realistic, known source
           Anxiety Disorders
• Phobia: an irrational, persistent fear of an
  object, situation, or social activity
  – social phobia (social anxiety disorder): fear of
    interacting with others or being in social
    situations that might lead to a negative
    evaluation
  – specific phobia: fear of objects or specific
    situations or events
              Phobic Disorders
• Phobic disorders (phobias) involve persistent,
  irrational fears and avoidance of the situations or objects
  that induce these fears. They may be the most common
  form of anxiety. There are different types of phobias.
• Claustrophobia: fear of being in a small, enclosed space
• Acrophobia: fear of heights
• Agoraphobia: fear of being in a place or situation from
  which escape is difficult or impossible
   – diagnosis requires that one feels anxiety in at least
     two of five situations
          Anxiety Disorders
• Panic disorder: panic attacks occur
  frequently enough to cause the person
  difficulty in adjusting to daily life
  – panic attack: sudden onset of intense panic in
    which multiple physical symptoms of stress
    occur, often with feelings that one is dying
           Anxiety Disorders
• Generalized anxiety disorder (GAD): excessive
  anxieties and worries occur more days than not
  for at least 6 months
Obsessive-Compulsive Disorder
• Obsessive-compulsive disorder: intruding,
  recurring thoughts or obsessions create
  anxiety that is relieved by performing a
  repetitive, ritualistic behavior (compulsion)
Disorders of Trauma and Stress
• Acute stress disorder (ASD): a disorder
  resulting from exposure to a major,
  traumatic stressor
  – symptoms include anxiety, dissociation,
    recurring nightmares, sleep disturbances,
    problems in concentration, and moments in
    which people seem to relive the event in
    dreams and flashbacks
  – lasting as long as one month after the event
Disorders of Trauma and Stress
 • Posttraumatic stress disorder (PTSD):
 When the symptoms associated with ASD
       last for more than one month
 – symptoms of PTSD may not develop until more than 6 months
   after a traumatic event
  Causes of Anxiety Disorders
• Psychodynamic explanations point to
  repressed urges and desires that are
  trying to surface, creating anxiety that is
  controlled by the abnormal behavior
• Behaviorists believe that disordered
  behavior is learned through both positive
  and negative reinforcement
   Causes of Anxiety Disorders
• Cognitive psychologists believe that excessive
  anxiety comes from illogical, irrational thought
  processes
    Causes of Anxiety Disorders
• Irrational thinking
   – magnification: the tendency to interpret situations as far
     more dangerous, harmful, or important than they
     actually are
   – all-or-nothing thinking: the belief that one’s
     performance must be perfect or the result will be a total
     failure
   – overgeneralization: the interpretation of a single
     negative event as a never-ending pattern of defeat and
     failure
   – minimization: the tendency to give little or no importance
     to one’s successes or positive events and traits
    Causes of Anxiety Disorders
• Biological explanations of anxiety disorders
   – chemical imbalances in the nervous system
   – genetics
   – More(over) activity in amygdala and limbic system
• Cultural variations
   – ataque de nervios - Puerto Rican syndrome - 'attack of
     nerves'
   – Koro is a culture-specific syndrome in which an individual has an
     overpowering belief that his or her genitalia are retracting and will
     disappear, despite the lack of any true longstanding changes to the
     genitals.
   – taijin kyofusho (TKS) is a Japanese culture-specific
     syndrome. The term taijin kyofusho translates into the disorder
     (sho) of fear (kyofu) of interpersonal relations (taijin).[
          Disorders of Mood
• Affect: in psychological terms, emotion or
  mood
• Mood disorders: disorders in which mood
  is severely disturbed
  – major depressive disorder: severely
    depressed mood that comes on suddenly and
    seems to have no external cause
     may include thoughts of death or suicide
     most common of diagnosed disorders of mood
           Disorders of Mood
• Mood Disorders (cont’d)
  – seasonal affective disorder (SAD): a mood disorder
    caused by the body’s reaction to low levels of
    sunlight in the winter months
  – manic episode: a period of excessive excitement,
    energy, and elation or irritability
  – bipolar disorder: periods of mood that may range from
    normal to manic, with or without episodes of
    depression (bipolar I disorder), or spans of normal
    mood interspersed with episodes of major depression
    and episodes of hypomania (bipolar II disorder)
The Range of Emotions
Most people experience a range of emotions over the course of a day
or several days, such as mild sadness, calm contentment, or mild
elation and happiness. A person with a mood disorder experiences
emotions that are extreme and, therefore, abnormal.
    Causes of Mood Disorders
• Behavioral theories link depression to learned
  helplessness
• Cognitive theories see depression as the result
  of distorted, illogical thinking
• Biological explanations of mood disorders look
  at the function of serotonin, norepinephrine, and
  dopamine systems in the brain
  – genetic origins
                 Eating Disorders
Anorexia nervosa (anorexia): a condition in which a
person reduces eating to the point that their body
weight is significantly low, or less than minimally
expected
 - in adults, this is likely associated with a BMI less than 18.5
           Eating Disorders
• Bulimia nervosa (bulimia): a condition in
  which a person develops a cycle of
  “binging,” or overeating enormous
  amounts of food at one sitting, and then
  using unhealthy methods to avoid weight
  gain
• Binge-eating disorder also involves
  uncontrolled binge eating but differs from
  bulimia primarily in that individuals with
  binge-eating disorder do not purge
           Eating Disorders
• Causes of eating disorders
  – greatest risk factors appear to be someone
    being an adolescent or young adult female
  – genetic components appear to be significant
• Culture and eating disorders
  – less common in non-Western cultures
  – different values placed on eating and on
    starvation for socially-recognized reasons
       Dissociative Disorders
• Dissociative disorders: disorders in which
  there is a break in conscious awareness,
  memory, the sense of identity, or some
  combination thereof
  – dissociative amnesia: loss of memory for
    personal information, either partial or
    complete
       Dissociative Disorders
• Dissociative Disorders (cont’d)
  – dissociative fugue: traveling away from
    familiar surroundings with amnesia for the trip
    and possible amnesia for personal information
  – dissociative identity disorder (DID): disorder
    occurring when a person seems to have two
    or more distinct personalities within one body
      Dissociative Disorders
• Dissociative Disorders (cont’d)
  – depersonalization/derealization disorder:
    dissociative disorder in which sufferers feel
    detached and disconnected from themselves,
    their bodies, and their surroundings
Development of Dissociative Disorders
• Psychodynamic explanations point to
  repression of memories, seeing
  dissociation as a defense mechanism
  against anxiety
• Cognitive and behavioral explanations see
  dissociative disorders as a kind of
  avoidance learning
Development of Dissociative Disorders
• Biological explanations point to lower than
  normal activity levels in the areas
  responsible for body awareness in people
  with dissociative disorders
          Schizophrenia
• Schizophrenia: severe disorder in which
  the person suffers from disordered
  thinking, bizarre behavior, and
  hallucinations, and is unable to distinguish
  between fantasy and reality
• Psychotic: the break away from an ability
  to perceive what is real and what is
  fantasy
              Schizophrenia
• Delusions: false beliefs held by a person
  who refuses to accept evidence of their
  falseness
  – delusions of persecution
  – delusions of reference
  – delusions of influence
  – delusions of grandeur (or grandiose delusions)
• Speech and thought disturbances
              Schizophrenia
• Hallucinations: false sensory perceptions,
  such as hearing voices that do not really exist
• Flat affect: a lack of emotional responsiveness
• Catatonia: either wildly excessive movement
  or total lack thereof
                Schizophrenia
• Positive symptoms: excesses of behavior or occur
  in addition to normal behavior
  – hallucinations, delusions, and distorted thinking
• Negative symptoms: less-than-normal behavior or
  an absence of normal behavior
  – poor attention, flat affect, and poor speech production
       Causes of Schizophrenia
• Biological explanations
  of schizophrenia focus
  on dopamine, structural
  defects in the brain,
  inflammation, and
  genetic influences
Genetics and Schizophrenia
This chart shows a definite pattern: The greater the degree of genetic
relatedness, the higher the risk of schizophrenia in individuals related to each
other. The only individual to carry a risk even close to that of identical twins
(who share 100 percent of their genes) is a person who is the child of two
parents with schizophrenia. Based on Gottesman (1991).
       Causes of Schizophrenia
Stress-vulnerability model: assumes a biological
sensitivity, or vulnerability, to a certain disorder that
will develop under the right conditions of
environmental or emotional stress
        Personality Disorders
• Personality disorder: a disorder in which a
  person adopts a persistent, rigid, and
  maladaptive pattern of behavior that interferes
  with normal social interactions
  – Cluster A: seen as odd or eccentric (Paranoid,
    Schizoid, Schizotypal)
  – Cluster B: behavior is dramatic, emotional, or erratic
    (Antisocial, Borderline, Histrionic, Narcissistic)
  – Cluster C: the main emotion is anxiety or fearfulness
    (Avoidant, Dependent, Obsessive-Compulsive)
        Personality Disorders
• Antisocial personality disorder: a person
  has no morals or conscience and often
  behaves in an impulsive manner without
  regard for the consequences of that
  behavior - Cluster B
• Borderline personality disorder: maladaptive
  personality pattern in which the person is
  moody and unstable, lacks a clear sense of
  identity, and often clings to others - Cluster B
Causes of Personality Disorders
• Cognitive-learning theorists see
  personality disorders as a set of learned
  behavior that has become maladaptive
  – bad habits learned early on in life
  – belief systems of the personality disordered
    person are seen as illogical
• Biological explanations look at genetic
  factors and stress hormones
Causes of Personality Disorders
• Other possible causes of personality
  disorders may include disturbances in
  family communications and relationships,
  childhood abuse, neglect, overly strict
  parenting, overprotective parenting, and
  parental rejection
               Taking the
           Worry Out of Exams
• While not yet recognized as a clinical disorder in
  the DSM-5, test anxiety has caused countless
  students considerable stress and agony over the
  years
• Determine why you want to do well on the test in
  the first place
• Develop a strategy for controlling your cognitive
  state and behavior, both before and during the
  exam
Test preparation to reduce anxiety:
Approach the exam with confidence:
Use whatever strategies you can to personalize success:
visualization, logic, talking to your self, practice, team work,
journaling, etc.
View the exam as an opportunity to show how much you've
studied and to receive a reward for the studying you've done
Be prepared!
Learn your material thoroughly and organize what materials
you will need for the test. Use a checklist!
Retrieved from http://www.studygs.net/tstprp8.htm, 21 November 2015
Test preparation to reduce anxiety:
Choose a comfortable location for taking the test with good
lighting and minimal distractions
Allow yourself plenty of time, especially to do things you need
to do before the test and still get there a little early
Avoid thinking you need to cram just before the test
Strive for a relaxed state of concentration
Avoid speaking with any fellow students who have not
prepared, who express negativity, who will distract your
preparation
A program of exercise is said to sharpen the mind
Test preparation to reduce anxiety:
Get a good night's sleep the night before the exam
Don't go to the exam with an empty stomach Fresh fruits
and vegetables are often recommended to reduce stress.
Stressful foods can include processed foods, artificial
sweeteners, carbonated soft drinks, chocolate, eggs, fried
foods, junk foods, pork, red meat, sugar, white flour
products, chips and similar snack foods, foods containing
preservatives or heavy spices
Take a small snack, or some other nourishment to help
take your mind off of your anxiety.
Avoid high sugar content (candy) which may aggravate
your condition
  The End                                          Chapter 14
                                           psychological disorders
psychology
                       fourth edition
 Psychology, Fourth Edition                        Copyright ©2015, 2012, 2008 by Pearson Education, Inc.
 Saundra K. Ciccarelli • J. Noland White                                              All rights reserved.