Psychological disorders

1. Psychology, lecture 11 Winter 2017/2018 Jolanta Babiak Psychological disorders

2. Questions to think about • Have you ever worried excessively without any particular cause? • Have you been really anxious about your health without any physical symptoms of an illness? • Have you abused alcohol to escape a problem? • Has suicide ever crossed your mind? • Have you been sad for a prolonged period of time?

3. Psychopathology • Psychological functioning that is unhealthy or abnormal • Involves disruptions in emotional , behavioral and thought processes • Leads to personal distress • Inhibits achievement of life goals • [Abnormal psychology deals with understanding the character of individual disturbances (pathologies) of mind, mood and behavior]

4. Psychological disorders – how to decide that someone acts abnormally? • This decision depends on • Particular perspective • Training of the evaluator • Cultural background of the evaluator • The situation • Status of the person being judged as abnormal

5. Psychological disorders DSM-5 2013 • “The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) marks the first significant revision of the publication since the DSM-IV in 1994. • The Diagnostic and Statistical Manual of Mental Disorders (DSM) provides the standard language by which clinicians, researchers, and public health officials in the United States communicate about mental disorders.” World Psychiatry. 2013 Jun; 12(2): 92–98.  Published online 2013 Jun 4. doi:  10.1002/wps.20050 PMCID: PMC3683251 The DSM-5: Classification and criteria changes Darrel A Regier,1Emily A Kuhl,1 and  David J Kupfer2

6. 7 criteria of abnormal behavior based on DSM-IV-TR, 2000) • Distress or disability – personal experiences disabling normal functioning, e.g. weeping man • Maladaptiveness– behavior that obstructs individual goals or interferes with others’ goals, e.g. heavy drinking – loss of a job • Irrationality– irrational or incomprehensible behavior • Unpredictability – unpredictable behavior in various situation; loss of control, e.g. smashing the window for no reason • Unconventionality– statistically rare behavior and violations of social standards • Observer discomfort – e.g. person talking loudly to himself while walking down the street • Violation of moral and ideal standards – e.g. if someone does not wish to work for entire life

7. Distinction between normal and abnormal behavior • To label behavior as abnormal more than just one indicator shall be present • Degree to which a person’s actions meet criteria of abnormality • Mental disorder shall be considered a continuum – variations between mental health and mental illness • Problem with objectivity: judgement about someone’s behavior shall be made without any type of bias • David Rosenhan experiment (1973) – ‘it is impossible to be judged sane in an insane place’

8. Etiology of psychopathology • Biological approach – structural abnormalities in the brain, biochemical process, genetic influences • Psychological approaches – causal role of psychological or social factors in the development of psychopathology, e.g. personal experiences, traumas, conflicts, environmental factors • Interactionists approach – genetic predispositions may make a person vulnerable to psychological disorder and coupled with psychological and social stress may make the disorder to fully develop

9. Psychological causes of psychopathology • Psychodynamic– causes of the psychopathology located inside the person: processes of psychic conflict and ego defense; conflict arises from struggles between pleasure-seeking impulses of the id and internalized constraints of the superego; ego is trying to resolve it; individual is using defense mechanism to avoid the pain of this conflict (repression or denial); the expenditure of the psychic energy is so big that it may lead to self-defeating behavior • Behavioral – abnormal behaviors are acquired through learning and reinforcement (just like normal behavior); behaviorists rely on classical and operant conditioning to understand abnormal behavior • Cognitive– takes into account the perception and thinking about oneself and relationships with other people: distortions in perception of the reality of a situation, faulty reasoning, poor problem-solving; perception about the degree of control, ability to cope with problems, interpretations of events • Sociocultural– culture may impact the diagnosis of abnormal behavior

10. Anxiety disorders • General anxiety disorder – feeling anxious and worried for more than 6 months, when not threatened plus feeling muscle tension, fatigue, restlessness, poor concentration, irritability, sleep difficulty (at least 3) • Panic disorder – unexpected, severe panic attacks • Phobias– persistent, excessive, irrational fear of a specific object , activity or situation: social, animal, closed spaces, heights, etc. • Obsessive-compulsive disorder – obsessions are thoughts, images or impulses that persists despite efforts to suppress them; compulsions are purposeful repetitive acts performed in responses to obsessions • Post-traumatic stress disorder – anxiety disorders characterized by persistent re-experiencing of traumatic event

11. Mood disorders and personality disorders • Major depressive disorder – dysphoric mood (dysphoria a severe state of dissatisfaction and uneasiness) , appetite, sleep, motor activity, guilt, concentration, suicide • Bipolar disorder – periods of severe depression alternating with manic episodes • Borderline personality (emotionally unstable personality disorder) – experiences of great instability and and intensity in personal relationships, arise from difficulty to control anger, impulsivity related to self-harm • Antisocial personality disorder – prolonged pattern of irresponsible, unlawful, violating social norms behavior; not experiencing shame for hurtful actions; indifference to the rights of others

12. Bibliogrpahy • Gerrig R.J. (2012). Psychology and Life, London, Pearson Education, Ltd. – chapter 14