CHAPTER EIGHTEEN

Psychological Disorders

SECTION 1

What Are Psychological Disorders?

Quick Definitions

Psychological Disorders: patterns of thoughts or behaviors that interfere with lives or cause suffering

Culture-Bound Syndromes: what we consider a disorder may actually be considered normal in other areas

Did You Know?

How many Americans suffer from psychological disorders?

Studies vary, but the results range from one-fourth up to half!

For the test, we’ll say: One-third of adults in the United States

have experienced some type of psychological disorder.

Symptoms

1. Typicality—is the behavior average of the rest of society?

2. Maladaptive Behavior—determines whether the behavior is harmful to self or others

3. Emotional Discomfort—if a person suffers from extreme or long-lasting feelings of hopelessness or helplessness

4. Socially Unacceptable Behaviors—actions that violate society’s norms

Classifying Psychological Disorders

It’s important to have a system for classifying disorders for diagnosis and treatment.

Disorders were first classified based on their presumed causes.

Today, psychologists use the DSM-IV to classify disorders. DSM-V: Diagnostic and Statistical Manual of

Mental Disorders; 5th edition (first published in 1960)

SECTION 2

Anxiety Disorders

Introduction

Description: a general state of uneasiness or dread that occurs in response to a vague or imagined danger

Characteristics: nervousness, inability to relax, concern about losing control

Physical Signs: trembling, sweating, rapid heart rate, shortness of breath, increased blood pressure, flushed face, feelings of faintness

A problem when this happens all the time and is out of proportion to the situation

Types of Anxiety Disorders

• Phobic disorder• Panic Disorder• Generalized Anxiety Disorder• Obsessive Compulsive Disorder• Compulsive Hoarding Syndrome• Post Traumatic Stress Disorder

Phobic Disorder

A lot of us say we have phobias, but we really don’t

Description: an excessive/irrational fear of a certain subject or situation

Diagnosed when the fear leads to avoidant behavior and changes in a person’s life

Panic Disorder

1/75 people have this disorder

Have recurrent and unexpected panic attacks A short period of intense fear/discomfort with

shortness of breath, dizziness, rapid heart beat, trembling/shaking, sweating, nausea, choking, and more

Generalized Anxiety Disorder

Description: an excessive and unrealistic worry about life in general that lasts for six months or more

Worry about: finances, work, relationships, accidents, illnesses, etc.

Obsessive-Compulsive Disorder

Obsessions: unwanted thoughts, ideas, or mental images that occur over and over again; often senseless

Compulsions: repetitive, ritual behaviors; often involve checking and cleaning

Sufferers usually know their obsessions and compulsions are unwarranted

Compulsive Hoarding Syndrome

Characterized by the excessive collection of items, along with the inability to discard them

Often creates cramped living conditions, with only narrow pathways winding through stacks of clutter

Leads to limited interaction with others

Post Traumatic Stress Disorder

Description: intense, persistent feelings of anxiety caused by a traumatic experience (rape, war, abuse, assault, accident, etc.)

Symptoms: flashbacks, nightmares, numbness of feelings, avoidance, increased tension and jumpiness

Psychological ViewsPsychological Views Biological ViewBiological View

Learned in childhood

A cover for forbidden urges

Due to feelings of worthlessness

A negative response to a situation

It’s genetic—we inherit these obsessions and compulsions from our parents

Explanation

SECTION 3

Dissociative Disorders

Background Information

Dissociation refers to the separation of personality components or mental processes from conscious thought

The most common form of “normal” dissociation is daydreaming

Dissociation removes stress or lessens anxiety

There are four disorders we’re going to discuss.

Dissociative Amnesia

Characteristic: a sudden loss of memoryMay last a few hours or several yearsOften appears after a traumatic experience

and returns with little noticeUsually doesn’t occur again

Dissociative Fugue

Characteristics forget information and events Relocate Develop a new identity

Most common during wars and natural disasters

Just like in the soap operas!

Dissociative Identity Disorder

Also known as Multiple Personality DisorderCharacteristic: two or more personalities

exist in one personEach personality is different from each otherA history of severe child abuse is common

with most DID patients (physical, sexual, or psychological)

Depersonalization Disorder

Characteristic: detachment from one’s mental processes and/or body

Explaining this Disorder

Psychoanalytic Psychologists A response to inappropriate urges

Learning Psychologists People have been taught not to think about disturbing

events

Most believe there is no link between dissociation and genetics

Gender Identity Disorder

Symptoms

Children Are disgusted by their own body parts Are rejected by their peers, feel alone Have depression or anxiety Say that they want to or will be the opposite sex

Adults Dress like or live the life of the opposite sex Feel alone Have depression or anxiety

Causes/Diagnosis

The cause is unknown

In order to diagnose this disorder, the feeling of being in the body of the "wrong" gender must last for at least two years

Treatment

Counseling: have the patient talk about the issues

Hormonal Therapy: give him/her the hormones that correspond with the gender he/she was born with

Sex Reassignment Surgery: your basic sex change

SECTION 4

Somatoform Disorders

Introduction

Definition: the expression of psychological distress through physical symptoms

This disorder is NOT intentional

Some diagnosed cases are reversed because a medical illness is found!

Some cases go unreported because the focus is on medical tests.

Conversion Disorder

Description: experience a change in or loss of physical functioning in a major part of the body with no medical reason

Example: when a person cannot move his/her legs or see at night

Some people are unconcerned about these symptoms!

Hypocondriasis

Also known as hypochondriaDescription: a person’s

unrealistic preoccupation with the fear he/she has a serious disease

Example: when a person is sure a belly ache is actually stomach cancer

Some people will see several doctors until one gives them any form of treatment!

Explanation

A person converts psychological stress into actual medical problems

Example: a pilot afraid to fly since September 11th may develop problems with his/her vision

Impulse Control Disorders

Description

defined primarily by loss of control

characterized by an inability to resist the impulse to perform an action that is harmful to one's self or others

Intermittent Explosive Disorder

Intermittent Explosive Disorder

the inability to control violent impulses result in serious damage to either persons or

propertythe degree of the aggressiveness is not in

proportion to cause

Trichotillomania

Hair loss caused by compulsive pulling or twisting of the hair until it breaks off An uneven appearance to the hair Bare patches or all around loss of hair Constant tugging, pulling, or twisting of hair Denying the hair pulling

Patients say they have a sense of relief, pleasure, or gratification after the hair pulling

These symptoms are usually seen in children

Kleptomania

Involves the compulsive stealing of items that aren’t needed

There is usually a feeling of tension before stealing, and a sense of pleasure at the time of the theft

A rare problem; more common in women

Pathological Gambling

The uncontrollable impulse to gamble

It often results in disrupted relationships, financial problems, and/or criminal behavior and yet the individual can’t stop

Often are obsessed with gambling and need to increase the amount of money gambled in order to experience the same rush

Pyromania

Involves setting fires for pleasureThe individual usually has a significant

fascination with fireExperience a sense of relief or gratification

from the experience

Treatment

Some of the disorders are helped by behavior therapy Reduce stress and help the patient develop other

habits

There may also be a neurological explanation (there’s something wrong in the brain) Treat with anti-depressants

SECTION 5

Mood Disorders

Introduction

Mood changes refers to being “up” or “down” depending on life experiences

Becomes a disorder when changes are inappropriate or inconsistent

SAD HAPPY

Major Depression

Another one of the most common disorders

Effects over 100 million people worldwide

A person must have five of the nine symptoms which must occur every day for two weeks

Depressed mood Loss of interest in

activities Weight loss or gain Sleeping more or less Faster/slower reactions—

physically and emotionally Loss of energy Feeling worthless or guilty Unable to concentrate or

make decisions Thoughts of death or

suicide

Bipolar Disorder

Also known as manic depression

Characterized by dramatic ups and downs; changes quickly for no reason at all

The depressive characteristics are the same as major depression

There are five characteristics of the manic stage Inflated self-esteem Inability to sit still or

sleep Racing thoughts Pressure to talk to

switch topics Difficulty

concentrating

Explanation

Psychological Views Learned helplessness It is simply a person’s

habit

Biological Views Heredity A chemical imbalance;

due to low levels of serotonin

SECTION 6

Schizophrenia

Introduction

Most serious disorderVery rare; .5% - 1% suffer from this disorderCharacterized by a loss of contact with realityCan develop gradually or very quicklyWorsens over timeVery difficult to treat20% with schizophrenia will attempt suicide;

10% of the attempts are successfulOften starts between 18-25

Symptoms

Hear VoicesHallucinations: see things that aren’t there

Can be visual or auditory

Delusions: believe things to be true that aren’t; often believe they can do things they can’t and that they’re better than they are

Thought Disorders Organization: skip around Content: repetition

Social WithdrawalCatatonic Stupor: an immobile, expressionless, coma-

like state

Explanation

GeneticsInjury or trauma at birthBirth during a winter monthA viral infection during infancyA brain defect

SECTION 7

Personality Disorders

Description

Patterns of inflexible traits that disrupt social life or work and/or distress the affected individual; are major components of a person’s personality

Effects up to 10% of the population

Types of Disorders

Paranoid: distrustful and suspicious of others, see others as harmful and evil, threatening and insulting

Schizoid: no interest in relationships with others, lack normal emotional responses

Antisocial: show disregard for others and violate the rights of others with no guilt or remorse

More Types of Disorders

Avoidant: want relationships, but are afraid; act shy and withdrawn

Borderline: have unstable relationships and an unstable self-image

Dependent: clingy and submissive

Histrionic: excessively emotional; always need attention

Explanation

Not clearly explained until the 1980sWere rejected by adults as children, severely

punishedReinforced negative behaviorsgenetics