Psychological Disorders

The same behavior may be deemed normal under some circumstances but

abnormal in others.

Abnormal behavior is psychopathology

What is Normal vs. What is Abnormal

Abnormal behavior is based on a combination of : 1) Unusualness – experienced by only a few; the behavior is statistically significant - the occurrence of that behavior is low (rare); 2) Social deviance – All societies establish standards or social norms that define socially acceptable behaviors. Deviation from these norms (the standards of the society) is often used as a criterion for labeling behavior as abnormal; what is the situational context? 3) Emotional distress – i.e., anxiety or depression are considered abnormal when inappropriate, excessive, or prolonged relative to the person’s situation; what is the subjective discomfort? 4) Maladaptive behavior – Behavior is maladaptive when it causes personal distress, is self-defeating, is associated with significant health, social, or occupational problems, or the behavior does not allow the person to fit into the situational context.

5)*Dangerousness – Violent or dangerous behavior that is outside the sanctioned context, that behavior could be viewed as being abnormal; and 6) Faulty perceptions or interpretations of reality – i.e., Hallucinations – involves distorted perceptions of reality; Delusions – fixed but unfounded beliefs.

Abnormality or psychological disorder, then, is any pattern of behavior that causes people significant ____________, causes them to ___________ themselves or others, or harms their ability to ________________ in daily life.

Must have at least two criteria to form a diagnosis of abnormality

1. Is the behavior _______________? 2. Does the behavior go against social

norms? 3. Does the behavior cause the person

significant subjective discomfort? 4. Is the behavior maladaptive? 5. Does the behavior cause the person to be

___________________ to self or others?

Cultural Bases of Abnormal Behavior

Psychologists are now taking into account the cultural context when making judgments about abnormal behavior. This is called the sociocultural perspective.

Cultural relativity refers to the unique characteristics of the culture in which a person with a disorder was nurtured to be able to correctly diagnose and treat the disorder.

Culture-bound syndromes – refers to psychological disorders occurring in only one or a few cultures.

MODELS OF ABNORMAL BEHAVIOR: Early Beliefs – From ancient times through the Middle Ages, people thought that those displaying abnormal behavior were controlled by supernatural forces or possessed by demonic spirits.

Models of Abnormality

*The Biological/Medical Model – Is based on the belief that abnormal behavior patterns represent mental illnesses that have a biological cause and can be classified by their particular characteristics or symptoms. This model explains disorders such as anxiety, depression, and schizophrenia as caused by ___________________, genetic problems, brain damage and dysfunction, or some combination of those causes.

*Psychological Models – The first major psychological model of abnormal behavior was the psychodynamic model developed by Sigmund Freud. Freud believed that abnormal behavior arises from __________________ conflicts during childhood that remain unresolved. Freud explained disordered behavior as being the result of repressing one’s threatening thoughts, memories, and concerns in the unconscious mind. These repressed thoughts and urges try to resurface, and disordered behavior develops as a way of keeping the thoughts repressed. Therefore, psychological symptoms are merely the outward expressions of inner turmoil; unconscious conflicts are at the root of abnormal behavior patterns.

*The Behavioral model is based on the belief that most forms of abnormal behavior are __________________ in the same ways that normal behavior is _________________.

*The Humanistic model argues that human beings possess an intrinsic ability to make conscious choices and to strive toward self-actualization. Therefore, abnormal behavior develops when people encounter ____________________ on the path toward personal growth or self-actualization.

*The Cognitive model believes that __________________ or distorted thinking leads to emotional problems and maladaptive behavior.

*The Sociocultural Model argues that abnormal behavior may have more to do with social ills or failures of _________________ than with problems within the individual. Socioculltural theorists believe that the stress of coping with poverty and social disadvantage can eventually take its toll on mental health.

The Biopsychosocial Model argue that most forms of abnormal behavior are not simply products of biology or environment alone; rather, they result from complex interactions of biological, psychological, and sociocultural factors. **An example of the biopsychosocial model is the diathesis-stress model.

**According to the diathesis-stress model, certain people have a vulnerability or predisposition called a diathesis, which increases their risks of developing a particular disorder.

*WHAT ARE PSYCHOLOGICAL DISORDERS? They are distinctive patterns of abnormal behavior that involves a disturbances of mood, behavior, thought processes, or perception that result in significant personal distress or impaired functioning.

Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision

(DSM-IV-TR)

The DSM-IV-TR describes about 250 different psychological disorders. Each disorder is described in terms of its __________________, the typical _________ the disorder takes as it progresses, and a checklist of specific criteria that must be met in order for the diagnosis of that disorder to be made. Each disorder is broken down into 5 categories or axes.

Axis I: Clinical Disorder and Other Conditions that may be a Focus of Clinical Attention.

Axis II: Personality Disorders and Mental Retardation Axis III: General Medical Conditions Axis IV: Psychosocial and Environmental Problems Axis V: Global Assessment of Functioning

Anxiety Disorders

Anxiety disorders refer to a class of psychological disorders characterized by excessive or inappropriate anxiety reactions. The major types are: phobias, panic disorder, generalized anxiety disorder, and obsessive-compulsive disorder. Free-floating anxiety is anxiety that is ________________ to any realistic, known source.

Phobias are irrational or excessive fears of particular objects or situations. The three types are: social phobia, specific phobia, and agoraphobia. Persons with social phobia have an intense fear of social interactions. Persons with specific phobia have an excessive fear of specific situations or objects. Persons with agoraphobia have a fear venturing into open places or going out in public; they cannot avoid their phobia’s source because it is simply being _______________ in the real world.

Panic Disorders Panic Disorders is a type of anxiety disorder involving

repeated episodes of sheer terror called panic attacks. Panic attacks are characterized by intense physical symptoms that includes profuse sweating, numbness or tingling, and pounding of the heart. These symptoms may lead people to think they are having a heart attack, or are losing control.

Obsessive-Compulsive Disorder – Is a disorder in which intruding, recurring thoughts or obsessions create anxiety that is relieved by performing a repetitive, ritualistic behavior(compulsion).

Generalized Anxiety Disorder – Refer to persons that experience persistent anxiety that is not tied to any particular object or situation for at least six months. The person seems to worry incessantly.

Causes of Anxiety Disorders CAUSES OF ANXIETY DISORDERS – Freud explained anxiety

as being a kind of danger signal that repressed urges or conflicts were threatening to surface.

Behaviorist argue that anxious behavioral reactions are learned. Cognitive psychologist view anxiety disorders as the result of

illogical, irrational thought processes, e.g. Magnification – the tendency to interpret situations as far more _______________, harmful, or ________________ than they actually are. All-or-nothing thinking – the tendency to believe that one’s performance must be_____________ or the result will be a total failure. Overgeneralization – the tendency to interpret a single _______________ event as a never ending pattern of defeat and failure. Minimization – the tendency to give ______________________ importance to one’s successes or positive events and traits.

Biological Factors – Causes of Anxiety Disorders

**Biological factors – One possibility is that biochemical changes in the ________________ involving neurotransmitter imbalances trigger a kind of internal alarm system that induces feelings of panic in susceptible people. Also, General anxiety disorder has been linked to an imbalance in several neurotransmitters in the nervous system, including lower levels of both serotonin and GABA (Gamma-Aminobutyric Acid – involved in the regulation of sleep and anxiety).

Psychological Factors – Some phobias may be learned through classical conditioning in which a previously neutral or benign stimulus becomes paired with an aversive stimulus.

People with high levels of anxiety sensitivity, or fear of fear (phobophobia) itself, may overreact to anxiety symptoms, which in turn can lead to escalating anxiety that culminates in a full-fledged panic attack.

Anxiety disorders reflect the interplay of biological and psychological factors. Anxiety disorders are found around the world, although the particular form the disorder

takes might be different in various cultures, e.g., ataque de nervios that occurs in some Latin cultures.

Somatoform Disorders: Sickness as a State of Mind

Somatoform disorders are viewed as being a psychological defenses against anxiety. They are disorders that take the form of bodily illnesses and symptoms but for which there are no real physical disorders.

Psychophysiological disorder is the modern term for psychosomatic disorder. Psychosomatic disorders are disorders in which ________________________ stress causes a real physical disorder or illness.

______________________ Is a somatoform disorder in which the person is terrified of being sick and worries constantly, going to doctors repeatedly, and becoming preoccupied with every sensation of the body.

Somatization disorder is a somatoform disorder in which the person dramatically ________________ of a specific symptom such as nausea, difficulty swallowing, or pain for which there is no real physical cause.

More Somatoform Disorders

__________________ are limited to those functions controlled by the somatic nervous system. Symptoms are the loss of motor and/or sensory functions. The person may experience dramatic, sudden, and specific symptoms such as blindness, paralysis, deafness, or numbness of certain body parts, none of which have real physical causes. Like somatization disorder, conversion disorder usually occurs when a stressful situation has also occurred or is threatening to occur, such as a soldier facing the return to combat.

Causes of Somatoform Disorders

Dissociative Amnesia – People with dissociative amnesia experience a loss of memory for information about themselves or their life experiences. The absence of any physical cause for their amnesia suggests that the disorder is psychological in nature.

CAUSES OF DISSOCIATIVE DISORDERS: Dissociative amnesia may represent an attempt to disconnect or dissociate one’s conscious state from awareness of traumatic experiences or other sources of psychological pain or conflict.

Somatoform Disorders – Refer to persons that have physical ailments or complaints that cannot be explained medically.

Conversion Disorder – Refers to persons that suffer a loss of physical function, such as loss of movement in a limb (hysterical paralysis), loss of vision (hysterical blindness), or loss of feeling in a hand or arm (anesthesia). Yet there is no physical cause that can account for these symptoms.

Hypochondriasis – Refers to persons preoccupied with the idea that there is something terribly wrong with their health. They attribute their physical complaints or symptoms to a serious underlying disease.

Causes of Somatoform Disorders

According to Freud, the hysterical symptom (loss of movement in a limb) is the outward sign of an unconscious dynamic struggle between opposing motives. The ego seeks to protect the self from the flood of anxiety that would occur if these unacceptable impulses were to become fully conscious.

Secondary gain is the reward value of having a psychological or physical symptom, such as release from ordinary responsibilities.

Mood Disorders

Mood Disorders involves persons that have a persistent or severe disturbances of mood; not just an occasional up and down swing.

Major Depressive Disorder – Is the most common type of depressive disorder, characterized by periods of downcast mood, feelings of worthlessness, and loss of interest in pleasurable activities. When left untreated, it can last months, even a year or more.

Seasonal affective disorder (SAD) is a type of major depression that involves a recurring pattern of winter depressions followed by elevations of mood in the spring and summer.

Dysthymic disorder (dysthymia) is a relatively mild but chronic form of depression.

Bipolar Disorder – Are characterized by alternating moods that shift between euphoric feelings and depression. The two major types of bipolar disorders are: bipolar disorder and cyclothymic. Persons with bipolar disorder experience mood swings between periods of manic episodes and periods of depression.

Cyclothymic disorder is characterized by a pattern of milder mood swings than those seen in bipolar disorder.

Causes of Mood Disorders

Psychological Factors – The classic psychodynamic theory espoused by Freud held that depression involves anger turned inward against the self.

Cognitive theorists focus on how our thoughts and interpretations of events contribute to emotional disorders such as depression. Another psychological model of depression, the learned helplessness model, suggests that people become depressed when they come to believe that they are helpless to control the reinforcements in their lives.

Attributional style is the way in which a person explains the outcome of events in his or her life.

Depressive attributional style is the characteristic way of explaining negative events in terms of internal, stable, and global causes.

Biological factors play important roles in depression, including irregularities in neurotransmitter functioning, abnormalities in neural pathways, and genetics. Serotonin is a key brain chemical in regulating moods.

Why people commit suicide?

Irregularities in serotonin functioning can result in a disinhibition effect- the removal of inhibitions that might otherwise constrain impulsive behavior, including impulses to commit suicide.

SCHIZOPHRENIA – Is a severe and chronic psychological disorder characterized by disturbances in thinking, perception, emotions, and behavior.

Psychotic disorder is characterized by a break with reality. Thought disorder is the breakdown in the logical structure of thought and speech, revealed in the form of a loosening of associations.

Types of Schizophrenia

Disorganized Type is characterized by confused behavior and disorganized delusions, among other features.

Catatonic type is characterized by bizarre movements, postures, or grimaces.

Paranoid type is characterized by the appearance of delusional thinking accompanied by frequent auditory hallucinations.

Causes of Schizophrenia

Genetic Factors play an important role in determining the risk of developing schizophrenia.

Biochemical Imbalances in the nerve pathway in the brain that utilize the neurotransmitter dopamine appears to contribute to the development of schizophrenia.

PERSONALITY DISORDERS are a cluster of psychological disorders characterized by excessively rigid patterns of behavior. These behavioral patterns become self-defeating because they make it difficult for people to adjust to external demands and interfere with their relationships with others.

Narcissistic personality disorder is characterized by a grandiose sense of self.

Paranoid personality disorder is characterized by extreme suspiciousness or mistrust of others.

Schizoid personality disorder is characterized by social aloofness and limited range of emotional expression.

Borderline personality disorder is characterized by unstable emotions and self-image.

Antisocial personality disorder is characterized by callous attitudes toward others and by antisocial and irresponsible behavior.

Suicide Prevention

1) Recognize the seriousness of the situation – Don’t fall for the myth of thinking that people who talk about suicide are not truly serious; 2) Take implied threats seriously – Some suicidal people don’t come right out and say they are planning to kill themselves; 3) Express understanding – Engage the person in conversation to allow his or her feelings to be expressed; 4) Focus on alternatives – Tell the person that other ways of dealing with his or her problems may be found; 5) Assess the immediate danger – Ask the person whether he or she has made a specific plan to commit suicide; 6) Enlist the person’s agreement to seek help – Insist that the person accompany you to a health professional or nearby hospital emergency room; and

7) Accompany the person to seek help – Above all, don’t leave the person alone.

Say: It’s Possible for a better life! By Les Brown

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