Understanding Psychological Disorders: What Defines Abnormal Behavior?

1. General Psychology Chapter 12 The Psychological Disorders

2. What is “Abnormal”? • Abnormalrefers to maladaptive affects, behaviors, and/or cognitions that are at odds with social expectations and result in distress or discomfort

3. Classifying Abnormal Reactions • Diagnosis– act of recognizing a disorder on the basis of a specified set of symptoms • The Diagnostic and Statistical Manual of Mental Disorders(DSM) • DSM-IV lists 297 different diagnostic categories

4. Table 12.1: The multiaxial classification system of the DSM-IV-TR.

5. Problems with Classification & Labeling • Comorbidity – occurrence of two or more disorders in the same individual • Nearly 80% will have 2 or more disorders • Many psychological disorders are also comorbid with physical illness

6. A Word on “Insanity” • Insanity: • One did not know or fully understand the consequences of his or her actions at a given time • Could not discern the difference between right and wrong • And was unable to exercise control over his or her actions at the time a crime was committed

7. A Word on “Insanity” • Competence – whether one is in control of his or her mental and intellectual functions to understand courtroom procedures and aid in his or her own defense

8. A Few Cautions… • “Abnormal” and “normal” are not 2 distinct categories! • Abnormal does not mean dangerous • People jailed for violent crimes are no more likely to have a psychological disorder than not-jailed persons • Persons with psychological disorders are more likely (than persons without) to be victims of violent crimes • Abnormal also does not mean BAD!

9. Anxiety Disorders • Anxiety – feeling of general apprehension or dread accompanied by predictable physiological changes

10. Anxiety Disorders • Generalized anxiety disorder – major symptom is distressing, felt anxiety • Anxiety may be intense or diffuse • Anxiety can cause substantial interference

11. Anxiety Disorders • Panic Disorder – major symptom is more acute: a recurrent, unpredictable, unprovoked onset of sudden, intense anxiety, or a “panic attack” • Comorbid with depression = higher rate of suicide

12. Anxiety Disorders • Phobic disorder – persistent and excessive fear of some object, activity, or situation that consistently leads a person to avoid that object, activity, or situation • Specific phobia • Social phobia • Agoraphobia

13. Table 12.2: A sample of phobias.

14. Obsessive-Compulsive Disorder • OCD – anxiety disorder characterized by a pattern of recurrent obsessionsand compulsions • Obsessions– ideas or thoughts that involuntarily and constantly intrude into awareness • Compulsions– constantly intruding, repetitive, behaviors

15. Table 12.3: A few of the more common obsessions and compulsions found in patients with OCR.

16. Posttraumatic Stress Disorder • PTSD – distressing symptoms that arise some time after the experience of a highly traumatic event • Must have experienced, witnessed, or been confronted with an event that involves actual or threatened death or serious injury • Responses involve fear, helplessness, and horror • Flashbacks, Avoidance, Increased Arousal

17. Somatoform Disorders • Somatoform disorders – involve physical, bodily symptoms or complaints with no known medical or biological cause for the symptoms

18. Somatoform Disorders • Hypochondriasis – preoccupied with the fear of a serious disease • Somatization disorder – several, recurrent, long-lasting complaints about physical symptoms for which there is no cause • Conversion disorder – loss or altering of physical functioning that suggests a physical disorder, but without medical explanation. La belle indifference

19. Dissociative Disorders • Dissociative disorders – person seeks to escape from some aspect of life or personality seen as the source of stress, discomfort, or anxiety

20. Dissociative Disorders • Dissociative amnesia – inability to recall important personal information too extensive to be explained by ordinary forgetfulness • Dissociative fugue – amnesic forgetfulness is accompanied by a change of location

21. Dissociative Identity Disorder • Major symptom is the existence within the same person of two or more distinct personalities or traits • Dramatic and extreme personality changes • Take place without warning or provocation • Which personality will be dominant cannot be predicted or controlled • Child/sexual abuse

22. Personality Disorders • Long-lasting patterns of perceiving, relating to, and thinking about the environment and oneself that are maladaptive and inflexible and cause either impaired functioning or distress

23. Personality Disorders • Cluster I – includes disorders of odd or eccentric reactions, such as: • Paranoid personality disorder – extreme sensitivity, unjustified suspiciousness, envy, and mistrust of others • Schizoid personality disorder – inability to form, and an indifference to, personal relationships

24. Personality Disorders • Cluster II – disorders of dramatic, emotional, or erratic reactions, such as: • Histrionic personality disorder – someone who is overly dramatic, reactive, and demonstrates intensely expressed behavior • Narcissistic personality disorder – reflects a grandiose exaggeration of self-importance, a need for attention or admiration, and a tendency to set unrealistic goals

25. Personality Disorders • Cluster III – disorders involving anxiety and fearfulness, such as: • Avoidant personality disorder – an over-sensitivity to the possibility of being rejected by others and an unwillingness to enter into relationships for fear of being rejected • Dependent personality disorder – allowing and seeking others to dominate and assume responsibility for action; has poor self-image and lacks self-confidence

26. Personality Disorder • Antisocial personality disorder – an exceptional lack of regard for the rights and properties of others, accompanied by impulsive, often criminal, behaviors • Psychopaths/Sociopaths • Symptoms include deceit and manipulation of others without guilt or regret • More common among persons of low-SES

27. Alzheimer’s Dementia • Dementia – condition characterized by the marked loss of intellectual abilities • Alzheimer’s disease – slow deterioration of intellectual functioning accompanied by personality changes • Physical disease • Abnormal changes in brain tissue

28. Table 12.4: Ten warning signs of Alzheimer’s disease.

29. Alzheimer’s Dementia • Risk Factors for Alzheimer’s: • There is a genetic predisposition! • Obesity • Receiving a head injury

30. Alzheimer’s Dementia • Possibly reduces chances of Alzheimer’s: • Using folic acid in one’s diet • Engaging in cognitively challenging activities in old age

31. Mood Disorders • Major depression – diagnosis for a constellation of symptoms that includes feeling sad, low, and hopeless, coupled with a loss of pleasure or interest in most normal activities • Dysthymia – mild case of major depression, but it tends to be more chronic, or continuous

32. Mood Disorders • Bipolar Disorder – episodes of depression are occasionally interspersed with episodes of mania • Mania – elevated mood with feelings of euphoria or irritability and increased levels of activity

33. The Roots of Depression • There is evidence for a genetic, or inherited, predisposition to bipolar mood disorder • Researchers suspect that there is a genetic basis for major depression, as well

34. The Roots of Depression • Diathesis-stress model – the expression of disordered behaviors (particularly depression) results from the interaction of an inherited predisposition and the experience of stress or trauma • Biogenic amines • Brain anatomy

35. The Roots of Depression • Psychological Factors • These could include learning experiences, situational stress, and cognitive factors • Freud believed that depression was a reflection of early childhood experiences that leads to anger directed inwardly

36. Schizophrenia • Involves a distortion of reality and a retreat from other people. • Three dimensions of symptoms: • Negative symptoms – emotional and social withdrawal, reduced energy and motivation, apathy and poor attention

37. Schizophrenia 2. Positive symptoms: • Hallucinations – false perceptions • Delusions– false beliefs 3. Positive disorganized symptoms – disorders of thinking and speech, bizarre behaviors, inappropriate affect

38. Schizophrenia:Correlates of Negative Symptoms • Structural abnormalities in the brain • Clearer genetic basis • More severe complications at birth • A lower educational level • Poorer adjustment patterns before onset • Poorer prognosis

39. Schizophrenia:Correlates of Positive Symptoms • Excesses of the neurotransmitter dopamine • Relatively normal brain configuration • Severe disruptions in early family life • Overactivity and aggressiveness in adolescence • Relatively good response to treatment

40. Table 12.5: Classifying schizophrenia on the basis of negative and positive symptoms.

41. Schizophrenia • DSM-IV Subtypes: • Catatonic • Disorganized • Paranoid • Undifferentiated

42. Table 12.6: Types of schizophrenia described in the DSM-IV-TR.

43. What Causes Schizophrenia? • It has a genetic basis • It is a disease of the brain • Excess dopamine • Diathesis-stress model • Consensus that it is a complex disease of the brain, not a “disorder of living”

44. Spotlight: Disorder, Race, and Gender • African Americans are: • More likely to suffer from phobias and somatoform disorders than are Caucasian Americans • Less likely to suffer from depression, dysthymia, obsessive-compulsive, and anti-social personality disorder • Less likely to seek professional help

45. Spotlight: Disorder, Race, and Gender • Asian Americans report higher incidents of social anxiety and social phobias • When Native Americans experience a psychological disturbance, it is usually depression, posttraumatic stress disorder, or alcohol-related.

46. Spotlight: Disorder, Race, and Gender • Gender: • Women are significantly more likely to be diagnosed with depression • Men are more likely to be diagnosed with antisocial personality disorder