Psychological DisordersChapter 14:

Human AdjustmentJohn W. Santrock

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Chapter Outline

Understanding Abnormal Behavior

Anxiety Disorders

Dissociative Disorders

Mood Disorders

Schizophrenia

Personality Disorders

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14-3UNDERSTANDING ABNORMAL BEHAVIOR

Defining Abnormal BehaviorTheoretical Approaches to Psychological Disorders

Classifying Abnormal Behavior

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Defining Abnormal Behavior

Deviant - atypical behavior, deviates from acceptable norms

Maladaptive - interferes with person’s ability to function effectively

Personal distress - person does not feel right

Abnormal behavior = behavior that is deviant, maladaptive or personally distressful

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14-5Theoretical Approaches to Psychological Disorders

Causes of psychological disorders include biological, psychological, and sociocultural factors and the possibility of a combination of factors

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The Biological Approach

The biological approach attributes psychological disorders to organic, internal causes

Biological factors that contribute to psychological disorders:–abnormalities in brain structure

– imbalances in neurotransmitters or hormones

–disordered genes

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The Biological Approach

Medical model:–abnormalities are mental illnesses

– individuals afflicted are patients

–patients are treated by doctors, often with drugs

Medical model = describes psychological disorders as medical diseases with a biological origin

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The Psychological Approach

The psychodynamic, behavioral, social cognitive, and humanistic perspectives serve as foundations for understanding psychological factors in psychological disorders

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The Psychological Approach

Psychodynamic perspective - psychological disorders arise from unconscious conflicts that produce anxiety

Behavioral perspective - rewards and punishments in the environment shape abnormal behavior

Social cognitive perspective - environment, observational learning, expectancies, self-efficacy, self-control, and beliefs are key factors in abnormal behavior

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The Sociocultural Approach

Sociocultural approach - emphasis on larger social contexts in which a person lives (individual’s marriage or family, socioeconomic status, ethnicity, gender, culture)

Frequency and intensity of psychological disorders varies across cultures and depends on social, economic, technological, and religious aspects

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14-11An Interactionist Approach:

Biopsychosocial Biopsychosocial approach - abnormal behavior can

be influenced by:–biological factors (such as brain processes and heredity)

–psychological factors (such as distorted thoughts or low self-esteem)

–sociocultural factors (such as ineffective family functioning or poverty)

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14-12Classifying Abnormal Behavior -

DSM-IV-TR American Psychiatric Association first published

Diagnostic and Statistical Manual of Mental Disorders in 1952–DSM-IV-TR (4th edition, text revision) was published in

2000

–DSM-IV-TR has multiaxial system which classifies individuals on the basis of five dimensions, or axes

–DSM reflects the medical model

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The Issue of Labeling

DSM classification is controversial:– it labels as disorders what are thought of as everyday

problems

– it has bias toward finding something wrong

– it puts labels on people

Despite disadvantages, DSM-IV-TR is comprehensive and allows clinicians to make predictions

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Review - Learning Goal 1

–What is abnormal behavior?

–What factors might be involved in the etiology of psychological disorders?

–How does the Diagnostic and Statistical Manual of Mental Disorders classify psychological disorders and what are its advantages and disadvantages?

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ANXIETY DISORDERS

Generalized Anxiety Disorder

Panic Disorder

Phobia Disorders

Obsessive-Compulsive Disorder

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Generalized Anxiety Disorder

Anxiety disorders - psychological disorders that include:–motor tension (jumpiness, trembling, inability to relax)

–hyperactivity (dizziness, racing heart, perspiration)

–apprehensive expectations and thoughts

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Generalized Anxiety Disorder

Generalized anxiety disorder - consists of persistent anxiety over at least one month; the individual with this disorder cannot specify reasons for the anxiety

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Generalized Anxiety Disorder

About 4 million Americans from 18 to 54 years of age have generalized anxiety disorder

Biological factors include genetic predisposition and deficiency of the neurotransmitter GABA

Psychological and sociocultural factors include overly strict and critical parents and negative thoughts when stressed

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Panic Disorder

About 2.4 million Americans have panic disorder

Panic disorder = anxiety disorder marked by recurrent sudden onset of intense apprehension or terror

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Panic Disorder

Panic attacks strike without warning and produce:– severe palpitations

– shortness of breath

– chest pains

– trembling

– sweating

–dizziness

– feeling of helplessness

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Agoraphobia

Agoraphobia = cluster of fears centered around public places and being unable to escape or to find help should one become incapacitated

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Agoraphobia

People with agoraphobia have fears of:– crowded public places

– traveling away from home

– feeling confined

–being separated from a place or a person

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Panic Disorder

Biological factors in panic disorder include:–overreaction to lactic acid

–genetic predisposition

–overactive autonomic nervous system

–problems with neurotransmitters norepinephrine and GABA

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Panic Disorder

Psychological factors in panic disorder include:– stressful life event

– separation from loved one

– change in job

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14-25Adjustment Strategies

for Coping with Panic

1. Retreat

2. Divert your attention

3. Engage in deep breathing relaxation and positive self-talk

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Phobic Disorders

About 6.3 million Americans have a phobic disorder

Phobic disorder = anxiety disorder in which individual has irrational, overwhelming, persistent fear of a particular object or situation

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Phobic Disorders

Common phobias involve:– social situations–dogs–height–dirt– flying– snakes

Social phobia - intense fear of being humiliated or embarrassed in social situations

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Figure 14.3 Phobias

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14-29Figure 14.4 Social Phobias in

the United States

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Phobic Disorders

Biological factors:–genetic

–neural circuit (thalamus, amygdala, cerebral cortex)

–neurotransmitter serotonin

Psychological factors:–defense mechanisms

– learned fears

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Obsessive-Compulsive Disorder

About 3.3 million Americans have obsessive-compulsive disorder

Obsessive-compulsive disorder (OCD) = anxiety disorder; individual has anxiety-provoking thoughts that will not go away (obsession) and/or urges to perform repetitive, ritualistic behaviors to prevent or produce some future situation (compulsion)

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Obsessive-Compulsive Disorder

Common compulsions include:– checking

– cleansing

– counting

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Obsessive-Compulsive Disorder

Biological factors–genetic

–brain pattern

–depletion of neurotransmitter serotonin

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Obsessive-Compulsive Disorder

Psychological factors– life stress

–occupation change

–marriage change

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14-35Adjustment Strategies

for Coping with an Anxiety Disorder

1. Understand that effective treatments are available

2. Ask the therapist what training and experience he or she has in treating anxiety disorders

3. Expect therapist to conduct a thorough diagnostic evaluation

4. Recognize that the length of treatment required can vary

5. Recognize that if one treatment doesn’t work, another one will

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DISSOCIATIVE DISORDERS

Dissociative Amnesia and Fugue

Dissociative Identity Disorder

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Dissociative Disorders

Under extreme stress, individual’s conscious awareness becomes dissociated (separated) from previous memories

Dissociative disorders = psychological disorders that involve sudden loss of memory or change in identity

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Dissociative Amnesia and Fugue

Three types of dissociative disorders:–Dissociative amnesia - extreme memory loss caused by

extensive psychological stress

–Dissociative fugue - individual not only develops amnesia but also travels away from home and establishes new identity

–Dissociative identity disorder (DID) - individuals have two or more distinct personalities

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MOOD DISORDERS

Depressive Disorders

Bipolar Disorder

Causes of Mood Disorders

Suicide

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Mood Disorders

Two types of mood disorders:–depressive disorders

–bipolar disorder

Mood disorders = psychological disorders in which there is a disturbance in mood (prolonged emotion that colors the individual’s entire emotional state)

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Depressive Disorders

Major depressive disorder (MDD) - individual experiences a major depressive episode with symptoms lasting at least two weeks

Dysthymic disorder - more chronic and has fewer symptoms then major depressive disorder

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Depressive Disorders

Major depressive episode - individual experiences at least 5 symptoms for at least 2 weeks:–depressed mood most of the day– reduced interest or pleasure in most activities– significant weight change or significant appetite change– trouble sleeping or sleeping too much–psychomotor agitation or retardation– fatigue or loss of energy– feeling worthless or guilty–problems in thinking, concentration, or making decisions– recurrent thoughts of death and suicide

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14-43Adjustment Strategies

for Coping with Depression

For the Depressed Individual:

1. Recognize that feeling exhausted, worthless, helpless, and hopeless are part of the depression

2. See a therapist

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14-44Adjustment Strategies

for Coping with Depression

For Family and Friends:1. Help individual get competent diagnosis and treatment2. Offer emotional support3. Invite the depressed person to activities4. Encourage the depressed individual to participate in activities that he or she once enjoyed5. Don’t expect him or her to “snap out of it”

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Bipolar Disorder

–Most bipolar individuals experience multiple cycles of depression interspersed with manic episodes

Bipolar disorder = mood disorder characterized by extreme mood swings that include one or more episodes of mania

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Bipolar Disorder

Manic episode occurs when a person:– feels euphoric

–has tremendous energy

– is impulsive

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Biological Causes of Mood Disorders

Biological causes of mood disorders include:–heredity–neurobiological abnormalities–altered brain wave activity during sleep–decrease in brain metabolic activity–neuron death– imbalance of monoamine neurotransmitters

(norepinephrine, serotonin, dopamine)–hormones

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Psychological Factors in Mood Disorders

Psychodynamic theories emphasize childhood experiences that prevented the person from developing a strong, positive sense of self

Freud suggested depression is a turning inward of aggressive instincts

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14-49Behavioral Explanations

of Mood Disorders

Behavioral explanations include reduction of positive reinforcers

Learning Helplessness = occurs when individuals are exposed to aversive stimulation, such as prolonged stress, over which they have no control

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14-50Cognitive Explanations

of Mood Disorders Cognitive explanations include:

–Depressed individuals interpret life in a negative way

– Individuals with a pessimistic cognitive style are more likely to be depressed

Depressive realism - depressed individuals accurately view the world

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14-51Sociocultural Factors

in Mood Disorders Sociocultural factors

– Incidence and intensity of depression varies across cultures

Socioeconomic and ethnic factors– Individuals living in poverty are more likely to be depressed

Bipolar disorder occurs equally in men and women, but women are twice as likely to develop depression

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Suicide

Depression can cause individuals to want to commit suicide

–Suicide is third leading cause of death in U.S. adolescents

Females are more likely to attempt suicide, but males are more likely to actually commit suicide

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Suicide

Biological factors in suicide include:–genetic

– low levels of the neurotransmitter serotonin

–poor physical health

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Suicide

Psychological factors in suicide include:–psychological disorders

– traumas (such as sexual abuse)

–highly stressful circumstances

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Suicide

Sociocultural factors in suicide include:– loss of loved one

– family instability

– chronic economic hardship

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14-56Adjustment Strategies for Communicating

with Someone Threatening Suicide

1. Ask direct questions in a calm manner

2. Be a good listener and be supportive

3. Take the suicide threat seriously

4. Encourage the person to get professional help and assist him or her in getting help

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SCHIZOPHRENIA

Types of schizophrenia

Causes of schizophrenia

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Schizophrenia

About 2.2 million adults in the U.S. have schizophrenia One half of patients in mental hospitals are individuals

with schizophrenia

Schizophrenia = a severe psychological disorder characterized by a highly disordered thought processes

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Schizophrenia

Symptoms of schizophrenia include:–delusions

–hallucinations

–word salad

–bizarre behavior

–withdrawal

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Types of Schizophrenia

Disorganized schizophrenia - delusions and hallucinations that have no meaning

Catatonic schizophrenia - bizarre motor behavior, sometimes an immobile stupor

Paranoid schizophrenia - delusions of reference, grandeur, and persecution

Undifferentiated schizophrenia - disorganized behavior, hallucinations, delusions, and incoherence

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Causes of Schizophrenia

Biological factors in schizophrenia include:–heredity

–brain abnormalities

–high levels of the neurotransmitter dopamine

–enlarged ventricles in brain

– small frontal cortex in brain

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Causes of Schizophrenia

Psychological factors in schizophrenia include:– stress

Diathesis-stress model of schizophrenia - combination of biogenetic disposition and stress

Sociocultural factors in schizophrenia include:–poverty

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PERSONALITY DISORDERS

Odd or Eccentric Cluster

Dramatic or Emotionally Problematic Cluster

Anxious or Fearful Cluster

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Personality Disorders

Personality disorders = chronic, maladaptive cognitive-behavioral patterns that are thoroughly integrated into the individual’s personality

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Odd or Eccentric Cluster

The odd or eccentric cluster of personality disorders include:–Paranoid - suspicious of others

–Schizoid - inadequate social relationships

–Schizotypal - odd thinking patterns

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14-66Dramatic or Emotionally

Problematic Cluster The dramatic or emotionally problematic cluster

include:–Histrionic - tend to overreact

–Narcissistic - unrealistic sense of self-importance

–Borderline - emotionally unstable

–Antisocial - guiltless, law-breaking, self-indulgent, irresponsible, and intrusive

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Anxious or Fearful Cluster

The anxious or fearful cluster includes:–Avoidant - inhibited, but desire relationships

–Dependent - lack self-confidence

–Obsessive-compulsive - obsessed with rules