Pscyhology 101: Chapter14

Psychology, Fifth Edition, James S. NairneChapter 14

Chapter 14Psychological Disorders


What’s It For? Psychological Disorders

• Conceptualizing Abnormality

• Classifying Psychological Disorders

• Understanding Psychological Disorders


Conceptualizing Abnormality: Learning Goals

1. Evaluate the various criteria that have been used to define abnormality.

2. Discuss the legal definition of insanity.

3. Explain how the medical model classifies and categorizes abnormality.

4. Discuss the effects of diagnostic labeling.


Characteristics of Abnormal Behavior

• Behavior must fit at least several of the following criteria to be labeled abnormal:– Statistical deviance -- infrequency– Cultural deviance -- violates norms– Emotional distress -- unhappiness, torment– Dysfunction -- difficulties with daily living

• “Abnormal” behavior not a rigid category



The Concept of Insanity

• Insanity: A legal term defined as inability to understand that certain actions are wrong at the time of a crime– Under this definition, people with disorders

may be judged legally sane

• Famous cases in which the insanity defense succeeded: John Hinckley Jr., Jeffrey Dahmer

• Used in < 1% of criminal felony cases


Abnormality as a Disease: The Medical Model

• View that abnormal behavior is symptomatic of underlying “disease” that can be “cured” with appropriate therapy– Draws an analogy between mental and

physical illness

• A widely held view, but some question it– Causes of mental illness often unclear– Social, cultural context of symptoms is

important, more so than for physical illness


Problems Associated With Labeling

• Diagnostic labeling effects: Labels for psychological problems can become self-fulfilling prophecies– Make it difficult to recognize normal

behavior when it occurs– May increase likelihood of abnormal

behavior

• Rosenhan (1973): Participants faked disorders to enter psychiatric ward– Other patients saw through the deception,

but staff did not


Classifying Psychological Disorders: Learning Goals

1. Describe the DSM-IV-TR.2. Describe the common anxiety disorders.3. Describe the somatoform disorders.4. Describe the common dissociative

disorders.5. Describe the common mood disorders.6. Describe the characteristics of

schizophrenia.7. Describe the common personality disorders.


What Is the DSM-IV-TR?

• Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision– Published by the American Psychiatric

Association

• Used for the diagnosis and classification of psychological disorders– Intended to give objective, measurable

criteria for diagnosing disorders– Does not suggest therapies or treatments– Does not discuss possible causes


The Five Axes of the DSM-IV-TR

• “Axis” = Rating dimension

• Axis I: Major clinical disorders– Examples: Schizophrenia; substance

abuse

• Axis II: Personality disorders – Example: Paranoid personality disorder


The Five Axes, continued…

• Axis III: General medical conditions– Example: Diseases of the circulatory

system

• Axis IV: Psychosocial and environmental problems– Example: Homelessness

• Axis V: Global assessment of functioning scale


Anxiety Disorders

• Marked by excessive apprehension, worry that impairs normal functioning

• Generalized anxiety disorder: “Free-floating” anxiety, chronic worrying lasting over 6 months

• Panic disorder: Recurrent discrete episodes or attacks of extremely intense fear or dread– Many physical symptoms such as chest

pains– May be associated with agoraphobia (fear

of public places)


Anxiety Disorders, continued…

• Obsessive-compulsive disorder: Persistent, uncontrollable thoughts (obsessions) or compelling need to perform repetitive acts (compulsions)– Examples: Excessive cleaning, checking

• Phobic disorders: Highly focused, irrational fear of a specific object or situation (e.g., snakes)

• Social anxiety disorder: Extreme anxiety in everyday social situations, often accompanied by physical symptoms



Anxiety Disorders: Gender and Culture

• Women are more likely to suffer from anxiety disorders than are men– Explanations focus on socialization

differences between men and women

• Anxiety disorders occur in all cultures, but the focus of the anxiety can differ


Somatoform Disorders

• Psychological disorders that focus on the physical body

• Hypochondriasis: Long-lasting preoccupation with idea that one has a serious disease, based on misinterpretation of normal body reactions

• Somatization disorder: Long-lasting preoccupation with body symptoms that have no physical cause

• Conversion disorder: Real physical problems that seem to have no physical cause


Somatoform Disorders: Gender and Culture

• Somatization and conversion disorders occur somewhat more frequently in women than in men

• Hypochondriasis occurs equally often in men and women

• Somatoform disorders occur cross-culturally but with some culturally specific expressions– e.g., koro -- Asian men– e.g., dhat -- men in India


Dissociative Disorders

• Characterized by separation, or dissociation, of conscious awareness from previous thoughts or memories

• Dissociative amnesia: Inability to remember important personal information– Generally psychological in origin

• Dissociative fugue: Loss of personal identity, often accompanied by a flight from home


Dissociative Identity Disorder

• Individual alternates between what appear to be two or more distinct identities or personalities– Also known as multiple personality disorder

• Recognized by DSM-IV-TR, but not all clinicians believe in it– Some symptoms can be faked; others,

such as optical changes, less easy to fake– Some clinicians view it as role-playing



Mood Disorders

• Prolonged, disabling disruptions in emotional state

• Two types:– Depressive disorders: Individual suffers

mainly from depression– Bipolar disorders: Mood swings between

depression and extreme highs called manic states


Major Depressive Episode

• Five or more of these symptoms for at least 2 weeks:– Depressed mood for most of the day– Loss of interest in normal daily activities– Significant weight change– Change in activity level– Daily fatigue or loss of energy– Negative self-concept – Trouble concentrating or making decisions– Suicidal thoughts


Suicide

• One possible consequence of mood disorders, including bipolar disorder– Third leading cause of death among

adolescents, eighth leading among all ages– Risk factors besides mood disorders

include alcohol use, stressful events

• Another major predictor: Prior suicide attempts and thoughts– Suicidal thoughts are a serious warning

sign


Bipolar Disorder: Mania

• Manic state: Person becomes hyperactive, talkative, decreased need for sleep

• Manic state must last at least a week to be classified as such, but may last for months

• Note that functioning is often severely impaired


Mood Disorders: Gender and Culture

• Around the world, women more likely than men to suffer from major depression

• Women more likely than men to attempt suicide; men more likely to succeed

• No gender difference for bipolar disorder

• Symptoms of depression are similar across cultures, though content of depressive thoughts varies somewhat


Schizophrenia

• Involves fundamental disturbances in thought processes, emotion, and/or behavior

• Complex disorder that may be expressed in a variety of ways– Diagnosis comes from a variety of

symptoms


Schizophrenia

• Positive symptoms: Observable expressions of abnormal behavior– Hallucinations– Delusions– Disorganized speech

• Negative symptoms: Elimination or reduction of normal behavior– Flat affect: Little or no emotional reaction to

events– Refusing to take care of self


Schizophrenia: Gender and Culture

• Men at slightly greater risk than women for schizophrenia

• Men tend to develop schizophrenia earlier in life than do women

• Schizophrenia occurs worldwide, but there are some racial differences in diagnosis rates in the U.S.


Personality Disorders

• Chronic, enduring patterns of behavior leading to significant impairment in social functioning– Tendency to act inflexibly

• Examples:– Paranoid personality disorder– Dependent personality disorder– Antisocial personality disorder

• Some clinicians view these as extremes of personality rather than disorders per se


Understanding Psychological Disorders: Learning Goals

1. Explain how biological and genetic factors can contribute to psychological disorders.

2. Discuss how maladaptive thoughts can contribute to psychological disorders.

3. Explain how environmental factors can contribute to psychological disorders.


Biological Factors

• Include physical problems with the body, brain, as well as genetic influences

• Neurotransmitter imbalances:– Dopamine excess in schizophrenia– Serotonin involved in mood disorders, but

exactly how is less clear

• Structural problems in the brain:– Schizophrenia associated with enlarged

ventricles


Genetic Contributions

• Do some people inherit predispositions toward developing disorders?

• Genetic component of schizophrenia: – Likelihood of having it increases with

closeness of a relative who also has it– Highest likelihood for identical twin

(chances are 1 in 2)

• Similar pattern for depression, bipolar disorder



Cognitive Factors

• Maladaptive thought patterns may contribute

• Maladaptive attributions– Internal, stable, global attributions for

negative experiences may play a role in depression

• Learned helplessness: Acquired when people repeatedly fail in attempts to control environment– May also contribute to depression



Environmental Factors

• Do people learn to act abnormally?

• Role of culture– A culture that emphasizes thinness may

predispose you to anorexia nervosa– Cultural background may influence the

kinds of delusions seen in schizophrenia

• Conditioning may play a role as well– Specific phobias may be acquired through

classical conditioning or observational learning

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Pscyhology 101: Chapter14