Chapter 13: Psychological Disorders

1. Chapter 13: Psychological Disorders

2. What is Normal? • Psychopathology: Scientific study of mental, emotional, and behavioral disorders • Subjective Discomfort: Private feelings of anxiety, depression, or emotional distress • Statistical Abnormality: Having extreme scores on some dimension, such as intelligence, anxiety, or depression • Social Nonconformity: Disobeying societal standards for normal conduct; may lead to destructive or self-destructive behavior

3. What Is Normal? (cont.) • Situational Context: Social situation, behavioral setting, or general circumstances in which an action takes place • Is it normal to walk around strangers naked? If you are in a locker room and in the shower area, yes! • Cultural Relativity: Judgments are made relative to the values of one’s culture

4. Figure 13.1

5. Clarifying and Defining Abnormal Behavior (Mental Illness) • Maladaptive Behavior: Behavior that makes it difficult to function, to adapt to the environment, and to meet everyday demands • Mental Disorder: Significant impairment in psychological functioning • Those with mental illness lose the ability to control thoughts, behaviors, or feelings adequately

6. Clarifying and Defining Abnormal Behavior (Mental Illness) (cont.) • Psychotic Disorder: Severe psychiatric disorder characterized by hallucinations and delusions, social withdrawal, and a move away from reality • Organic Mental Disorder: Mental or emotional problem caused by brain pathology (i.e., brain injuries or diseases)

7. Clarifying and Defining Abnormal Behavior (Mental Illness) (cont.) • Mood Disorder: Disturbances in affect (emotions or moods), like depression or mania • Anxiety Disorder: Disruptive feelings of fear, apprehension, anxiety, or behavior distortions that are anxiety-related

8. Clarifying and Defining Abnormal Behavior (Mental Illness) (cont.) • Substance Related Disorders: Abuse or dependence on a mind or mood-altering drug, like alcohol or cocaine • Person cannot stop using the substance and may suffer withdrawal symptoms if they do

9. Clarifying and Defining Abnormal Behavior (Mental Illness) (cont.) • Somatoform Disorder: Physical symptoms that mimic disease or injury (blindness, anesthesia) for which there is no identifiable physical cause • Dissociative Disorder: Temporary amnesia, multiple identity, or depersonalization (like being in a dream world, feeling like a robot, feeling like you are outside of your body) • Personality Disorder: Deeply ingrained, unhealthy, maladaptive personality patterns

10. Clarifying and Defining Abnormal Behavior (Mental Illness) (cont.) • Sexual and Gender Identity Disorder: Problems with sexual identity, deviant sexual behavior, or sexual adjustment • Neurosis: Archaic; once used to refer to excessive anxiety, somatoform, dissociative disorders, and some kinds of depression

11. General Risk Factors for Contracting Mental Illness • Social Conditions: Poverty, homelessness, overcrowding, stressful living conditions • Family Factors: Parents who are immature, mentally ill, abusive, or criminal; poor child discipline; severe marital or relationship problems

12. General Risk Factors for Contracting Mental Illness (cont.) • Psychological Factors: Low intelligence, stress, learning disorders • Biological Factors: Genetic defects or inherited vulnerabilities; poor prenatal care, head injuries, exposure to toxins, chronic physical illness, or disability

13. Insanity • Definition: A legal term; refers to an inability to manage one’s affairs or to be aware of the consequences of one’s actions

14. More on Insanity • Those judged insane (by a court of law) are not held legally accountable for their actions • Can be involuntarily committed to a psychiatric hospital • Some movements today are trying to abolish the insanity plea and defense; desire to make everyone accountable for their actions • How accurate is the judgment of insanity?

15. Expert Witness • Person recognized by a court of law as being qualified to give expert testimony on a specific topic • May be psychologist, psychiatrist, and so on

16. Personality Disorders: Antisocial Personality Disorder (APD) • Definition: A person who lacks a conscience (superego?); typically emotionally shallow, impulsive, selfish, and manipulative toward others • Oftentimes called psychopaths or sociopaths

17. APD Characteristics • Many are delinquents or criminals, but many are NOT crazed murderers displayed on television • Create a good first impression and are often charming • Cheat their way through life • May be blind to signs of disgust in others

18. APD: Causes and Treatments • Possible Causes: • Childhood history of emotional deprivation, neglect, and physical abuse • Tend to be thrill-seekers • Underarousal of the brain • Very difficult to effectively treat; will likely lie, charm, and manipulate their way through therapy

19. Anxiety-Based Disorders • Anxiety: Feelings of apprehension, dread, or uneasiness • Adjustment Disorders: When ongoing stressors within the range of normal experience cause emotional disturbance and push people beyond their ability to effectively cope

20. More on Anxiety-Based Disorders • Usually suffer sleep disturbances, irritability, and depression • Examples of Stresses: Grief reactions, lengthy physical illness, unemployment

21. Anxiety-Based Disorders Concluded • Anxiety Disorders: When distress seems greatly out of proportion to the situation at hand • Generalized Anxiety Disorder (GAD): Duration of at least six months of chronic, unrealistic, or excessive anxiety; worries about work, relationships, ability, or impending disaster

22. Panic Disorder (without Agoraphobia) • A chronic state of anxiety with brief moments of sudden, intense, unexpected panic (panic attack) • Panic Attack: Feels like one is having a heart attack, going to die, or is going insane • Symptoms include vertigo, chest pain, choking, fear of losing control

23. Panic Disorder (with Agoraphobia) • Panic attacks and sudden anxiety still occur, but with agoraphobia

24. Agoraphobia Characteristics • Intense, irrational fear that a panic attack will occur in a public place or in an unfamiliar situation • Intense fear of leaving the house or entering unfamiliar situations • Can be very crippling • Literally means fear of open places or market (agora)

25. Agoraphobia (withoutPanic Disorder) • Fear that something extremely embarrassing will happen away from home or in an unfamiliar situation

26. Specific Phobias • Irrational, persistent fears, anxiety, and avoidance that focus on specific objects, activities, or situations • People with phobias realize that their fears are unreasonable and excessive, but they cannot control them

27. Social Phobia • Intense, irrational fear of being observed, evaluated, humiliated, or embarrassed by others (e.g., shyness, not eating or speaking in public) in social situations • Barbara Streisand, Woody Allen perhaps?

28. Obsessive-Compulsive Disorder (OCD) • Extreme preoccupation with certain thoughts and compulsive performance of certain behaviors

29. Obsession • Recurring images or thoughts that a person cannot prevent • Cause anxiety and extreme discomfort • Enter into consciousness against the person’s will • Most common: Being dirty, wondering if you performed an action (turned off the stove), or violence (hit by a car)

30. Compulsion • Irrational acts that person feels compelled to repeat against his/her will • Help to control anxiety created by obsessions • Checkers and cleaners

31. Obsessive Compulsive Disorder

32. Stress Disorders • Occur when stresses outside range of normal human experience cause major emotional disturbance • Symptoms: Reliving traumatic event repeatedly, avoiding stimuli associated with the event, and numbing of emotions • Acute Stress Disorder: Psychological disturbance lasting up to one month following stresses from a traumatic event and that would produce anxiety in anyone who experienced them

33. Post Traumatic Stress Disorder (PTSD) • Lasts more than one month after the traumatic event has occurred; may last for years • Typically associated with combat and violent crimes (rape, assault, etc.) • The “War” in Iraq will likely lead to an increase of PTSD

34. Dissociative Disorders • Dissociative Amnesia: Inability to recall one’s name, address, or past • Dissociative Fugue: Sudden travel away from home and confusion about personal identity

35. Dissociative Identity Disorder (DID) • Person has two or more distinct, separate identities or personality traits; previously known as Multiple Personality Disorder • “Sybil” or “The Three Faces of Eve” are good examples • Often begins with horrific childhood experiences (e.g., abuse, molestation, etc.) • Therapy often makes use of hypnosis • Goal: Integrate and fuse identities into single, balanced personality

36. Somatoform Disorders: Hypochondriasis • Person is preoccupied with having a serious illness or disease • Interpret normal sensations and bodily signs as proof that they have a terrible disease • No organic cause can be found

37. Somatoform Disorders: Somatization Disorder • Person expresses anxieties through numerous physical complaints • Many doctors are consulted but no organic or physical causes are found

38. Somatoform Disorders: Pain Disorder • Pain that has no identifiable organic, physical cause • Appears to have psychological origin

39. Somatoform Disorders: Conversion Disorder • Severe emotional conflicts are “converted” into physical symptoms or a physical disability • Caused by anxiety or emotional distress but not by physical causes

40. Figure 13.4

41. Theoretical Causes of Anxiety Disorders: Psychodynamic • Freud: Anxiety caused by conflicts among id, ego, and superego

42. Some of Freud’s Concepts Regarding Anxiety • Forbidden id impulses for sex or aggression are trying to break into consciousness and thus influence behavior; person fears doing something crazy or forbidden • Superego creates guilt in response to these impulses • Ego gets overwhelmed and uses defense mechanisms to cope

43. Other Theoretical Causes of Anxiety Disorders • Humanistic: Unrealistic self-image conflicts with real self-image • Existential: Anxiety reflects loss of meaning in one’s life • Behavioristic: Anxiety symptoms and behaviors are learned, like everything else • Conditioned emotional responses that generalize to new situations

44. More Theoretical Causes of Anxiety Disorders • Avoidance Learning: When making a particular response delays or prevents the onset of a painful or unpleasant stimulus • Anxiety Reduction Hypothesis: When reward of immediate relief from anxiety perpetuates self-defeating avoidance behaviors • Cognitive: When distorted thinking causes people to magnify ordinary threats and failures, leading to anxiety and distress

45. Psychosis and Hallucinations • Psychosis: Loss of contact with shared views of reality

46. Delusions • False beliefs that individuals insist are true, regardless of overwhelming evidence against them

47. Hallucinations • Imaginary sensations, such as seeing, hearing, or smelling things that do not exist in the real world • Most common psychotic hallucination is hearing voices • Note that olfactory hallucinations sometimes occur with seizure disorder (epilepsy)

48. Some More Psychotic Symptoms • Flat Affect: Lack of emotional responsiveness; face is frozen in blank expression • Disturbed Verbal Communication: Garbled and chaotic speech; word salad • Personality Disintegration: Uncoordinated thoughts, actions, and emotions

49. Other Psychotic Disorders • Organic Psychosis: Psychosis caused by brain injury or disease • Dementia: Most common organic psychosis; serious mental impairment in old age caused by brain deterioration • Archaically known as senility • Common Causes: Circulatory problems, repeated strokes, shrinkage and atrophy of the brain

50. Alzheimer’s Disease • Symptoms include impaired memory, confusion, and progressive loss of mental abilities • Ronald Reagan was perhaps the most famous Alzheimer’s victim