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This text explores the historical perspective, etiology, and classification of psychological disorders. It covers topics such as abnormal behavior criteria, anxiety disorders, and the impact of cultural context.
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Myers’ PSYCHOLOGY (7th Ed) Chapter 16 Psychological Disorders James A. McCubbin, PhD Clemson University Worth Publishers
Psychological Disorders • Psychological Disorder • a “harmful dysfunction” in which behavior is judged to be: • atypical--not enough in itself • disturbing--varies with time and culture • maladaptive--harmful • unjustifiable--sometimes there’s a good reason
Historical Perspective • Perceived Causes • movements of sun or moon • lunacy--full moon • evil spirits • Ancient Treatments • exorcism, caged like animals, beaten, burned, castrated, mutilated, blood replaced with animal’s blood
Psychological Disorders • Medical Model • concept that diseases have physical causes • can be diagnosed, treated, and in most cases, cured • assumes that these “mental” illnesses can be diagnosed on the basis of their symptoms and cured through therapy, which may include treatment in a psychiatric hospital
Psychological Disorders • Bio-Psycho-Social Perspective • assumes that biological, sociocultural, and psychological factors combine and interact to produce psychological disorders
Psychological Disorders--Etiology • DSM-IV • American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) • a widely used system for classifying psychological disorders • presently distributed as DSM-IV-TR (text revision)
Psychological Disorders- Etiology • Neurotic Disorder (term seldom used now) • usually distressing but that allows one to think rationally and function socially • Psychotic Disorder • person loses contact with reality • experiences irrational ideas and distorted perceptions
Psychologists typically identify abnormal behavior based on a combination of the following criteria: • Unusualness • Social deviance • Emotional Distress • Maladaptive Behavior • Dangerousness • Faulty perceptions/interpretations of reality
Unusualness • Behavior that is experienced by only a few people may be abnormal, but not in all cases. • Unusualness, by itself, is not enough to be called abnormal.
Social Deviance • All societies establish social norms that define socially acceptable behaviors. • Deviation from these norms is often used as a criterion for labeling behavior as abnormal. • The same behavior might be considered abnormal in some contexts but acceptable in others.
Emotional Distress • States of emotional distress, such as anxiety or depression are considered abnormal when: • Inappropriate • Excessive • Prolonged • (relative to the person’s situation)
Maladaptive Behavior • Behavior is maladaptive when: • it causes personal distress • is self-defeating • is associated with significant health or social problems (alcohol or drug abuse)
Dangerousness • Violent or dangerous behavior • needs to be looked at in context
Faulty perceptions or interpretations of reality • Hallucinations: distorted perceptions of reality (seeing or hearing things that are not real) • Delusions: Fixed but unfounded beliefs are also distortions of reality (believing people are plotting against you)
Cultural context must be considered • The cultural context in which behavior occurs must also be evaluated when making judgments about whether behavior is abnormal.
Psychological Disorders • Anxiety Disorders: • Generalized Anxiety Disorder • Panic Disorder • Phobic Disorder • Post-traumatic Stress Disorder • Obsessive Compulsive Disorder
Generalized Anxiety Disorder: • GAD is characterized by persistent anxiety, unrelated to a specific event. • People suffering from GAD cannot help worrying about anything and everything, even in calm situations. • They have difficulty relaxing, falling asleep, and/or concentrating, and tend to be impatient and irritable.
Physical symptoms accompanying GAD include: • sweating; an upset stomach; diarrhea; frequent urination; cold, clammy hands; a lump in the throat; a dry mouth; shortness of breath; headaches; and dizziness.
Managing the normal demands of a job, relationships, and everyday life can become more and more difficult for people with this disorder. • GAD appears in four percent of the general population.
Panic Disorder • Panic attacks are sudden, unexplainable waves of panic that seem to come out of the blue. • The body responds with the "fight-or-flight" response, anticipating clear and immediate danger. • Often, these attacks subside as mysteriously as they occur.
A person who has experienced one or more panic attacks often develops a fear of having one again. • Some professionals call this a "fear of fear." • The individual may even try to stay away from anything that reminds him or her of the last attack to avoid having another one.
People can have panic attacks with or without agoraphobia. • These attacks include symptoms such as heart palpitations, shortness of breath, chest pain, feelings of choking or smothering, nausea, dizziness, sweating, and trembling. • An afflicted person might also be overwhelmed by a fear of dying, going crazy, or losing control.
Phobias: • Phobias are attempts to compartmentalize fear into a few situations that can be avoided. • By attaching all the panicky feelings onto a few situations, the person can avoid those situations and go on with life. • Unfortunately, phobias can take on a life of their own and take over more and more of a person's life.
A fear of dogs can, for example, be fairly easy to manage, just don't go near dogs. • But a fear of flying may limit social and business opportunities. • Some of the more common phobias include claustrophobia (fear of closed spaces), agoraphobia (fear of public places, sometimes related to panic attacks), and acrophobia (fear of heights).
Posttraumatic Stress Disorder: • Posttraumatic stress disorder (PTSD) can develop in the wake of a traumatic event that is outside the usual human experience. • A person either experiences direct or threatened injury, or witnesses the serious injury or death of another. • In some cases, learning of the unexpected death or injury of a loved one can also bring on symptoms of PTSD.
For a diagnosis of PTSD to be made, there must be both an identifiable terrifying event and a response of intense fear, helplessness and horror, as well as one or more characteristic symptoms. • These include re-experiencing of the event through: • nightmares • daytime flashbacks • physical sensations that recall the feelings present during the event.
PTSD Symptoms continued • Shutting down feelings and memory. • Feeling detached from others. • Dissociating from the distressing memories and feelings. • Hyperalertness to danger. The individual often has difficulty shutting down the fight-or-flight response that was activated during the event. This causes sleeplessness, irritability, difficulty concentrating, restlessness, and sometimes the development of an exaggerated startle. • Hypervigilance and avoidance of any situation associated with the event. • These symptoms significantly disrupt an afflicted person’s daily life.
Obsessive-Compulsive Disorder • Although classified as an anxiety disorder, obsessive-compulsive disorder (OCD) differs from these disorders in significant ways. • It is the one anxiety diagnosis that seems to have a clear biological cause. Unlike the other kinds of anxiety disorders, therapy alone isn't much help. Medication is also necessary. • OCD is a disorder in which the mind is flooded with involuntary thoughts, or in which an individual feels compelled to repeat certain acts over and over again (for example, hand washing).
This disorder can interfere significantly with everyday living, and usually leads to concern and/or resentment among friends, family, and co-workers. • A person who suffers from OCD doesn't want the thoughts and doesn't want to do the behaviors. Unfortunately, he or she really can't help it. • About half the people with OCD report that it began in childhood; most others start in adolescence or early adulthood. OCD affects approximately two percent of the general population.
Anxiety Disorders • Common and uncommon fears
Anxiety Disorders • PET Scan of brain of person with Obsessive/ Compulsive disorder • High metabolic activity (red) in frontal lobe areas involved with directing attention
Two Broad Categories of Mood Disorders • Depressive Disorders • Bipolar Disorders
Depressive Disorders • (1) Major Depressive Disorder (major depression) • The most common type of depressive disorder. • Characterized by periods of downcast mood, feelings of worthlessness, and loss of interest in pleasurable activities. • Is more common in women
Depressive Disorders Continued • (2) Seasonal Affective Disorder (SAD) • A type of major depression that involves a recurring pattern of Winter depressions followed by elevations in mood in the Spring and Summer. • More common in extreme northern climates
Depressive Disorders Continued • (3) Dysthymic Disorder • A relatively mild but chronic form of depression • Can last for months or years • More common in women
Bipolar Disorders • Characterized by alternating moods that shift between euphoric feelings and depression. • There are two major types: • (1) Bipolar disorder • (2) Cyclothymic disorder
Bipolar Disorder • Formerly called manic depression • Involves mood swings that shift between elevated moods or “euphoria” “manic” episodes and depression. • People with this disorder experience normal moods also. • Examples of manic behavior: • Extreme restlessness argumentativeness • Excitability lavish spending • Talkativeness reckless driving • Taking on tasks beyond a person’s ability
Bipolar Continued • Mania eventually gives way to depression: • Feelings of hopelessness and despair • Suicidal feelings • About 1% of the adult population in the U.S. suffers from bipolar disorder.
Cyclothymic Disorder • A mood disorder characterized by milder mood swings than bipolar disorder. • It is about as common as bipolar disorder.
Causes of Mood Disorders There are several possible causes which may occur separately or together to cause mood disorders:
Biological Causes • Brain chemicals: Neurotransmitters serotonin and norepinephrine may be too low in depressed people. • Genetic factors: There is a family connection • Faulty brain structure and function: Research is being done in this area to see if the structures responsible for emotions, etc. are different in depressed people.
Psychological Factors • Each approach to psychology has a theory of what causes depression. • Psychodynamic Theory (Freud) says depression is the result of anger turned inward against the self. • Learning Theory (Behaviorist) Depression is the result of changes in reinforcement levels. • Cognitive Theory: Says the way people interpret events, and distorted thinking can cause depression. • Learned Helplessness Theory: Says people become depressed when they feel powerless to control aspects of their lives
Mood Disorders-Depression • Canadian depression rates
Depressed state Manic state Depressed state Mood Disorders-Bipolar • PET scans show that brain energy consumption rises and falls with emotional switches
