Chapter 12

Chapter 12
Psychological Disorders

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Copyright © 2008 Allyn & Bacon

Chapter 12 Overview

 Defining psychological disorders
 Anxiety disorders
 Mood disorders
 Schizophrenia
 Other psychological disorders


Defining Psychological
Disorders
 Mental processes and/or behavior
patterns that cause emotional distress
and/or substantial impairment in
functioning


What criteria can be used to
determine whether behavior is
abnormal?
 Behavior may be considered abnormal if
– It is considered strange within a person’s own
culture
– It causes personal distress
– It is maladaptive
– It is a danger to the self or others
– A person is not legally responsible for his or her
acts


How do clinicians use the DSM-IV-
TR?

 The Diagnostic and Statistical Manual
of Mental Disorders (DSM-IV-TR)
provides a system for diagnosing and
classifying psychological disorders
 It describes about 300 specific disorders and
organizes them into categories


How prevalent are psychological
disorders?
Lifetime prevalence of
psychological disorders
 The lifetime
prevalence rate for
a psychological
disorder is nearly
50% among
Americans
 This is higher than
the lifetime
prevalence rate for
cancer (about 30%)


What are the theoretical
approaches that attempt to explain
the causes of psychological
disorders?
 Biological perspective
– Abnormal behavior arises from a physical cause
– Biological treatments, such as drug therapy, are favored
 Biopsychosocial perspective
– Psychological disorders result from a combination of
biological, psychological, and social causes
– Treatments that include drugs and psychotherapy are
employed
 Psychodynamic perspective
– Psychological disorders stem from childhood experiences
and unresolved, unconscious conflicts
– Treatment involves psychoanalysis


What are the theoretical
approaches that attempt to explain
the causes of psychological
disorders?
 Learning perspective
– Abnormal thoughts and behaviors are learned and
sustained like any other behaviors
– Treatment uses classical and operant conditioning and
modeling to extinguish maladaptive behavior and increase
adaptive behavior
 Cognitive perspective
– Faulty thinking and distorted perceptions can cause
– Treatment tries to change faulty, irrational, and/or
negative thinking


Anxiety Disorders

 Psychological disorders characterized
by frequent fearful thoughts about
what might happen in the future
 The most common category of
– Accounting for more than 4 million visits
to doctor’s offices in the US each year


What are the characteristics of
panic attacks and agoraphobia?
 Panic attack
– An episode of overwhelming anxiety, fear, or
terror
– The brains of panic-attack sufferers respond to
normal changes in the body as if they were life
threatening
 Agoraphobia
– Intense fear of being in a situation from which
escape is not possible if one experiences
overwhelming anxiety or a panic attack
– Often begins with repeated panic attacks
– People with agoraphobia sometimes plan their
entire lives around avoiding feared situations

How do the symptoms of four
common anxiety disorders differ?

 Generalized anxiety disorder
– Disorder involving chronic, excessive worry for
six months or more
 Panic disorder
– Disorder in which a person experiences
recurring, unpredictable episodes of
overwhelming anxiety, fear, or terror


How do the symptoms of four
common anxiety disorders differ?

 A phobia is a persistent, irrational fear of some
object, situation, or activity that poses little or no
real danger
– Social phobia
 Fear and avoidance of any social or performance situation in
which one might embarrass or humiliate oneself in front of
others
– Specific phobia is a fear of a specific object or situation,
a general label for any phobia other than agoraphobia or
social phobia
 Categories of specific phobias
– Situational phobias
– Fear of the natural environment
– Animal phobias
– Blood, injection, injury phobias


What thought and behavior
patterns are associated with
obsessive-compulsive disorder?
 Disorder in which a person suffers from
recurrent obsessions and/or compulsions
 Obsession
– A persistent, involuntary thought, image, or
impulse that causes great distress
 Compulsion
– A persistent, irresistible, and irrational urge to
perform an act or ritual repeatedly
– Compulsions often involve cleaning and washing,
counting, checking, touching objects, hoarding,
or excessive organizing

Mood Disorders

 Disorders characterized by extreme
and unwarranted disturbances in
emotion or mood


What are the symptoms of major
depressive disorder?

 A mood disorder marked by feelings of great
sadness, despair, and hopelessness as well
as loss of the ability to feel pleasure
– Symptoms also include changes in appetite,
weight, and sleep patterns, and difficulty
thinking or concentrating


What are the extremes of mood
suffered by those with bipolar
disorder?
 A mood disorder in which manic episodes
alternate with periods of depression, usually
with relatively normal periods in between
– Manic episodes are periods of excessive
euphoria, inflated self-esteem, wild optimism,
and hyperactivity, often accompanied by
delusions of grandeur and by hostility if activity
is blocked


What are some risk factors for
mood disorders?

 A small area in the prefrontal cortex, that
plays a role in controlling emotions, is
smaller than normal in people with major
depression
 Abnormal levels of serotonin are strongly
linked to depression
 People suffering from mood disorders have
abnormal production, transport, and
reuptake patterns for dopamine, GABA, and
norepinephrine

mood disorders?

 Heredity plays a role in mood disorders
– Twin studies indicate a genetic bases for bipolar
disorder and major depression
 Life stresses are also associated with
depression
– The majority of first episodes of depression
strike after major life stress


mood disorders?
Lifetime Risk for developing
 Prevalence of depression in 10 countries

depression varies
greatly across
cultures
 Prevalence rates also
differ between men
and women
– In most countries,
rate of depression in
females is about
twice that for males

What are some of the risk factors
for suicide?

 Depression, schizophrenia, substance abuse,
and a family history of suicide
 Risk of suicide also increases when people
are exposed to major life stressors
 Older white males commit suicide more
often than members of other race or age
groups
 Women are more likely to attempt suicide,
but men are more likely to succeed


Differences in suicide rates
according to race, gender, and age


Schizophrenia

 A severe psychological disorder
characterized by loss of contact with
reality, hallucinations, delusions,
inappropriate or flat affect, some
disturbance in thinking, social
withdrawal, and/or other bizarre
behavior


What are the positive and negative
symptoms of schizophrenia?

 Positive symptoms are abnormal
behaviors that are present in people with
schizophrenia
– Hallucinations
– Delusions
– Delusion of grandeur
– Delusions of persecution
– Disorganized behavior
– Inappropriate affect


What are the positive and negative
symptoms of schizophrenia?

 A Negative symptom is a loss or
deficiency in thought or behavior that is
characteristic of normal functioning
– Social withdrawal
– Apathy
– Loss of motivation
– Flat affect
– Limited speech and slow movements
– Poor hygiene and grooming


What are the four types of
schizophrenia?

 Paranoid schizophrenia
– Characterized by delusions of grandeur and
delusions of persecution
 Disorganized schizophrenia
– Characterized by extreme social withdrawal,
hallucinations, delusions, and bizarre behavior
 Catatonic schizophrenia
– Characterized by complete stillness or great
excitement and agitation
 Undifferentiated schizophrenia
– Term used when schizophrenic symptoms are
present, but do not conform to the criteria of
any one type Copyright © 2008 Allyn & Bacon

What factors increase the risk of
developing schizophrenia?

 There is probably no single cause of
schizophrenia
 Instead, several factors interact to produce
schizophrenia, including:
– Constitutional vulnerability
– Stress
– Neuromaturational processes



 Constitutional vulnerability refers to the
aspects of an individual’s congenital risk of
developing schizophrenia that are
attributable to factors of gender and
heredity
– Gender
 Males are more likely than females to develop
schizophrenia
– Heredity
 Chances of developing schizophrenia are higher if one
has a close genetic relative with schizophrenia


Genetic similarity and probability of
developing schizophrenia



 Stress
– Stressful events may trigger development of
schizophrenia in individuals with constitutional
vulnerability
 Neuromaturational processes
– Environmental factors may disrupt normal brain
development
 Causing decreased frontal lobe functioning, destruction
of gray matter, and abnormal dopamine activity


Other Psychological
Disorders
 Somatoform disorders
 Dissociative disorders
 Sexual disorders
 Personality disorders


What are two somatoform
disorders, and what symptoms do
they share?
 Disorders in which physical symptoms are
present that are due to psychological causes
rather than any known medical condition
 Hypochondriasis
– Characterized by excessive concern about one’s
health and fear that normal physical symptoms
are signs of serious disease
 Conversion disorder
– Disorder in which one suffers a loss of sensory
or motor functioning which has no physical
cause


How do the various dissociative
disorders affect behavior?

 Disorders in which consciousness becomes
dissociated from a person’s identity and/or
his or her memories
 Dissociative amnesia
– A complete or partial loss of the ability to recall
personal information and/or past experiences
 Dissociative fugue
– Complete loss of memory of one’s entire identity
and traveling away from home
 Often involves assuming a new identity

How do the various dissociative
disorders affect behavior?

 Dissociative identity disorder (DID) is a
disorder in which two or more distinct
personalities occur in the same person
– A host personality
– Alter personalities
 DID, like other dissociative disorders,
seems to be a response to unbearable
stress
– Among DID patients, at least 95% have history
of severe physical and/or sexual abuse

What are the main characteristics
of the various sexual disorders?

 Sexual disorders are disorders with a
sexual basis that are destructive, guilt- or
anxiety-producing, compulsive, or a cause
of discomfort or harm to one or both parties
involved
 Sexual dysfunctions
– Persistent and distressing problems involving
sexual desire, sexual arousal, or the pleasure
associated with sex or orgasm


What are the main characteristics
of the various sexual disorders?

 Paraphilias
– Recurrent sexual urges, fantasies, or behavior
involving nonhuman objects, children, other
nonconsenting persons, or the suffering or
humiliation of the person or his or her partner
 Gender identity disorder
– A problem accepting one’s identity as male or
female


What behaviors are associated with
personality disorders in Clusters A,
B and C?
 A personality disorder is a long-standing,
inflexible, maladaptive pattern of behavior and
relating to others, which usually begins in early
childhood or adolescence
 The DSM-IV-TR groups personality disorders into
clusters
– Cluster A
 Characterized by odd behavior, such as extreme
suspiciousness
– Cluster B
 Characterized by erratic, overly dramatic behavior
– Cluster C
 Characterized by intense feelings of anxiety

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Chapter 12