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History of Psychological Disorders
Psychological disorders were once understood as religious experiences, demonic possession, God’s punishment
Patients were treated as “mad,” imprisoned or executed for abnormalities
Medical model: the conceptualization of psychological abnormalities as diseases that, like biological diseases, have symptoms and causes and possible cures
How to Classify Disorders?
Diagnosis: determining the nature of the disorder
Symptoms: signs of an underlying problem or “syndrome”
DSM-IV-TR: a classification system that describes the features used to diagnose each recognized mental disorder and indicate how the disorder can be distinguished from other, similar problems
What is a “Disorder”?
DSM-IV-TR defines a disorder as Manifested in symptoms that involve
disturbances in behavior, thoughts, or emotions
Symptoms are associated with significant personal distress or impairment
Symptoms stem from an internal dysfunction (biological, psychological, or both)
NOT just deviation from what is “normal” Lots of behaviors—including positive ones
—aren’t perfectly normal, but not all signify psych disorders
What is a “Disorder” (Part 2)?
Different names for disorders Neurosis: a condition that involves anxiety or the
inability to properly sublimate psychical energy Psychosis: a condition in which a person
experiences serious distortions of perception and thought that weaken his/her grasp on reality
Anxiety Disorders: like neuroses; each subgroup is classified based on observable features
Controversy Many diagnoses continue to depend on
professional interpretation rather than factual, quantifiable observations
Many still rely on self-reports, which can be misleading!
Problems with Diagnosis
Disorders can arise from purely psychological, environmental, or genetic/biological factors—or some of each
Comorbidity: the co-occurrence of two or more disorders in a single individual A person might be depressed
because their social phobia makes interaction impossible, or a person could be phobic about showing their depression in public—or the disorders could be unrelated but co-occurring
Problems with Diagnosis (Part 2)
Diathesis-Stress Model A person may be predisposed for a mental
disorder that remains unexpressed until triggered by stress
Predispositions & environment can work in tandem Maria is predisposed to introversion, avoids
people for fear of rejection, gains a reputation as a loner, and is therefore rejected by others more often
Fundamental Attribution Error The tendency to ascribe behavior to
INTERNAL, essential causes rather than external, contingent ones Sitao comes to class with a bucket on his
head. Why?
Anxiety Disorders
Anxiety Disorder The class of mental disorder in which anxiety is
the predominant feature Generalized anxiety disorder, phobic disorder,
panic disorder, obsessive-compulsive disorder
Generalized Anxiety Disorder
GAD Unrelenting worries that are not focused on any
particular threat Chronic excessive worry is accompanied by three or
more of the following symptoms Restlessness Fatigue Concentration problems Irritability Muscle tension Sleep disturbances
Phobic Disorders
Marked, persistent, excessive fear and avoidance of specific objects, activities, or situations
Individuals recognize that phobias are irrational but can’t help but feel them
Specific phobia: an irrational fear of a particular objet or situation that markedly interferes with an individual’s ability to study Common phobias: animals; natural environments;
situations; blood, injections, and injury; social phobias Preparedness theory!
Panic Disorder
Different interpretations of physiological sins of anxiety Sodium lactate tests
Agoraphobia Extreme fear of venturing into public places Many are simply afraid of having panic
attacks in public
Sudden occurrence of multiple psychological and physiological symptoms that contribute to a feeling of stark terror Shortness of breath, heart palpitations,
sweating, dizziness, depersonalization ( feeling of being detached from one’s body) or derealization (feeling that the world is unreal)
Obsessive-Compulsive Disorder
Primary symptoms are unwanted, recurrent thoughts and actions; ritualistic behaviors (compulsions) designed to fend off those thoughts
Individuals are aware that symptoms are irrational
Obsessions typically derive from concerns that could pose a real threat (such as contamination, aggression, disease)
Psychotherapy is often as effective as medication
Dissociative Disorders
A condition in which normal cognitive processes are severely disjointed and fragmented, creating significant disruptions in memory, awareness, or personality that can vary in length from a matter of minutes to many years
Dissociative identity disorder: the presence within an individuals of two or more distinct identities that at different times take control of the individual’s behavior “Host” personality often does not know
about “alters,” but alters know about host and other alters
Dissociative Disorders (Part 2)
Dissociative amnesia: the sudden loss of memory of significant personal information
Dissociative fugue: the sudden loss of memory for one’s personal history, accompanied by an abrupt departure from home and the assumption of a new identity
Mood Disorders
Mood Disorders: mental disorders that have mood disturbance as their predominant feature
Major Depression Severely depressed mood that lasts 2 or more weeks and
is accompanied by feelings of worthlessness and lack of pleasure, lethargy, and sleep and appetite disturbances
Not necessarily SADNESS!
Facts Median lifetime risk for depression is about 16% and
seems to be increasing in younger generations Women are twice as likely to develop depression
(hormonal?)
Mood Disorders (2)
Bipolar Disorder An unstable emotional condition characterized
by cycles of abnormal, persistent high mood (mania) and low mood (depression)
Manic phase must last at least a week to qualify as mania Elevated mood, irritability, grandiosity,
decreased need for sleep, talkativeness, racing thoughts, distractibility, reckless behavior
Sometimes features hallucinations and delusions
Polygenic Arising from the action of many genes in an
additive or interactive fashion
Schizophrenia
Schizophrenia Profound disruption of basic psychological processes; a
distorted perception of reality; altered or blunted emotion; and disturbances in thought, motivation, and behavior
Symptoms emerge during continuous period of at least one month with signs of disorder persisting for at least six months Delusion Hallucination Disorganized speech Grossly disorganized behavior Catatonic Behavior Negative symptoms
Delusions
Patently false belief system, often bizarre and grandiose, that is maintained in spite of its irrationality
Adopted identities in schizophrenia do not alternate, exhibit amnesia for one another, or otherwise “split”
Delusions of persecution, paranoia
Hallucination
A false perceptual experience that has a compelling sense of being real despite the absence of external stimulation
Hearing seeing or smelling things that are not there or having tactile sensations in the absence of relevant sensory stimulation
65% report hearing voices repeatedly
Disorganized Speech
Severe disruption of verbal communication in which ideas shift rapidly and incoherently from one to another unrelated topic
“I have not been a drinker for 16 years. I am taking a mental rest after a ‘carter’ assignment of ‘quill.’ You know, a ‘penwrap.’ I had contracts with Warner Brothers Studios and Eugene broke phonograph records but Mike protested. I have been with the police department 35 years. I am made of flesh and blood—see Doctor?”
Grossly Disorganized Behavior
Behavior that is inappropriate for the situation or ineffective in attaining goals, often with specific motor disturbances
Improper sexual behavior, childlike behavior, disheveled appearance, loud shouting or swearing
Catatonic behavior A marked decrease in all movement
or an increase in muscular rigidity and over activity
Negative Symptoms
Emotional and social withdrawal; apathy; poverty of speech; and other indications of the absence or insufficiency of normal behavior, motivation, and emotion
Negative = things MISSING in people
Causes of Schizophrenia
Strong heritability coefficient
Monozygotic twins are highly likely to develop schizophrenia
Prenatal Factors Monozygotic twins generally share
same amniotic fluid Viral infections, toxins in mother’s
blood could contribute Higher chance of being
schizophrenic if born in winter months
Personality Disorders
Antisocial Personality Disorder Pervasive pattern of disregard for and violation of
the rights of others that begins in childhood or early adolescence and continues into adulthood
Signs before age of 15 include: aggression; destruction of property; rule violations; deceitfulness, lying, or stealing; repeatedly setting fires
APD individuals are often called “sociopaths” May be biologically predisposed to being insensitive
to fear
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