Chapter 12:

Psychological Disorders

What is Abnormal What is Abnormal Behavior?Behavior?

Behavior that is:Behavior that is:

Statistically unusualStatistically unusual

It is maladaptiveIt is maladaptive

Considered strange or undesirable by most Considered strange or undesirable by most peoplepeople

A source of unhappinessA source of unhappinessThere are biological, psychological (personal There are biological, psychological (personal standards), & socio-cultural factors involved standards), & socio-cultural factors involved in defining abnormal behavior.in defining abnormal behavior.

What is Normal What is Normal Behavior?Behavior?

Normality is Often Confused with Normality is Often Confused with Reality.Reality.

Reality is That Which is Perceived by Reality is That Which is Perceived by the Senses.the Senses.

Normal Behavior Agrees with or Normal Behavior Agrees with or Conforms to the Society’s Accepted Conforms to the Society’s Accepted Patterns of Customs, Rules, Laws, Patterns of Customs, Rules, Laws, Fears, and Taboos.Fears, and Taboos.

Classifying Mental Disorders

• Mental Disorder:Significant impairment in psychological functioning

• 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)

Classifying Mental DisordersClassifying Mental Disorders

• Mood DisordersMood Disorders– Disturbances in affect

(emotions), like depression or mania

• Anxiety DisordersAnxiety Disorders– Feelings of fear,

apprehension, anxiety, and distorted behavior that is anxiety related

– Some involve feelings of panic or phobias

• Somatoform Somatoform DisordersDisorders– Physical symptoms that

mimic disease or injury (blindness, anesthesia) for which there is no identifiable physical cause

• Dissociative Dissociative DisordersDisorders– Temporary amnesia,

multiple personality, or depersonalization

– like being in a dream world, feeling like a robot, feeling like you are outside of your body

Classifying Mental DisordersClassifying Mental Disorders

• Personality Disorders– Deeply ingrained, unhealthy, maladaptive personality

patterns

• Sexual and Gender Identity Disorders– Problems with sexual identity, deviant sexual behavior,

or sexual adjustment

• Substance Related Disorders– Abuse or dependence on a behavior or mood-altering

drug, like alcohol or cocaine– Person cannot stop using the substance and may suffer

withdrawal symptoms if they do

General Risk Factors Contributing to Mental Illness

• Psychological FactorsLow intelligence, stress, learning disorders

• Biological FactorsGenetic defects or inherited vulnerabilitiesPoor prenatal careLow birthweight

Head injuriesExposure to toxins or drugsChronic physical illness or disability

• Family FactorsSevere marital strifeChild abuse and very poor disciplineDisordered family communications patternsImmaturityMental problems

• Social ConditionsPoverty, overcrowding, &/or homelessnessStressful living conditionsSocial disorganization

Psychotic Disorders • Most dramatic and

serious of all disorders• Loss of contact with

reality marked by hallucinations, delusions, disturbed thoughts and emotions, and personality disorganization

• Included are:Organic Mental DisordersMood DisordersAnxiety DisordersSomatoform DisordersDissociative DisordersPersonality DisordersSexual & Gender Identity DisordersSubstance-related DisordersPsychotic Disorders

Psychotic Disorders: The Nature of Psychosis

• Delusions – False beliefs that

individuals insist are true, regardless of overwhelming evidence against them

– Common Types• Depressive• Somatic• Grandeur• Influence• Persecution• Reference

• 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

• May be tactile (e.g., things crawling on skin)

• Note that olfactory hallucinations sometimes occur with seizure disorder (epilepsy)

Psychotic Disorders: Psychotic Disorders: The Nature of PsychosisThe Nature of Psychosis

• Severely disturbed emotions • Flat Affect

– Lack of emotional responsiveness

• Disturbed Verbal Communication– Garbled and chaotic speech; word salad

• Personality Disintegration– Uncoordinated thoughts, actions, and

emotions of a psychotic individual

Psychotic Disorders:Organic Psychosis

• Psychosis caused by brain injury or disease– EX: Toxic chemical

poisoning (lead, mercury)

• Dementia – Serious mental

impairment in old age– Caused by brain

deterioration• Circulatory problems,

repeated strokes, general brain shrinkage or atrophy

– Results in disturbances in memory, reasoning, judgment, impulse control, and personality

– Alzheimer’s Disease is most common form

Delusional Delusional DisordersDisorders• Paranoid

Psychosis: – Most common

delusional disorder– Sufferers believe

they are being cheated, spied on, followed, poisoned, harassed, or plotted against.

– Intensely suspicious

– Difficult to treat • Hard to convince

person s/he needs help

Personality Personality DisordersDisorders

Inflexible, maladaptive ways of thinking & Inflexible, maladaptive ways of thinking & behaving learned in early life which cause behaving learned in early life which cause distress & conflict with others.distress & conflict with others.These behaviors impair personal or social These behaviors impair personal or social functioning & are a source of distress to the functioning & are a source of distress to the individual or to other people.individual or to other people.Included in these disorders are:Included in these disorders are:Schizotypal Personality DisorderSchizotypal Personality Disorder Schizoid Personality DisorderSchizoid Personality DisorderParanoid Personality DisorderParanoid Personality Disorder Dependant Personality DisorderDependant Personality DisorderAvoidant Personality DisorderAvoidant Personality Disorder Narcissistic Personality DisorderNarcissistic Personality DisorderBorderline Personality DisorderBorderline Personality Disorder Antisocial Personality Antisocial Personality

DisorderDisorderObsessive-Compulsive Personality DisorderObsessive-Compulsive Personality DisorderPassive-Aggressive Personality DisorderPassive-Aggressive Personality Disorder

Cluster 1 DisordersCluster 1 DisordersThese disorders are characterized by odd or eccentric behaviors or traits.

Schizoid Personality DisorderCharacterized by the inability to form social relationshipsWithdrawn with a lack of feelings toward others.

Schizotypal Personality DisorderUncomfortable in interpersonal relationships, & suffering from cognitive & perceptual distortions & eccentric behavior.May wear inappropriate, strangely out-of-date or mismatched clothes.

Paranoid Personality DisorderInappropriately suspicious of others & their motives.Guarded, secretive, devious, scheming, argumentative, & often superstitious.

Cluster 2 DisordersCluster 2 DisordersAntisocial Personality Antisocial Personality DisorderDisorderContinually violates the rights of others, prone to impulsive behavior, & feeling no guilt for any harm.

Unethical, exploitative, violent, criminal behavior.

Narcissistic Narcissistic Personality DisorderPersonality DisorderOver-inflated sense of self-importance.

Must be the center of attention, lacking any real empathy for others.

Cluster 3 DisordersCluster 3 DisordersCharacterized by Characterized by anxious or fearful anxious or fearful behavior.behavior.

Avoidant Avoidant personality personality DisorderDisorderHypersensitive to potential rejection by others, causing social withdrawal despite a desire for social relationships.

Has social anxiety & is timid, anxious, & fearful of relationships.

Obsessive-Compulsive Obsessive-Compulsive Personality DisorderPersonality DisorderPreoccupation with rules, schedules, & trivial details, & unable to express emotional warmth.

Preoccupied with orderliness & perfectionism.

Cluster 3 DisordersCluster 3 DisordersDependent Personality DisorderDependent Personality DisorderThe inability to make decisions or to act independently.

Fails to take responsibility for one’s own life, instead relies on other to make their decisions.

Can’t tolerate being alone.

Has a fear of abandonment.

Passive-Aggressive Personality Passive-Aggressive Personality DisorderDisorderUnassertive, indirect resistance to demands, as in forgetting, procrastinating, being late, and being indifferent.

Schizophrenic Schizophrenic DisordersDisorders

Types of Types of SchizophreniaSchizophrenia

Disorganized Disorganized TypeTypeOriginally called hebephrenicThere is an absence of and shallow emotions with bizarre & silly, child-like behaviors, poorly developed delusions, regressive behavior & verbal incoherence.

Catatonic TypeCatatonic TypeUnusual patterns of motor activity (e.g. rigid postures or extreme excitedness), will be either mute or extremely talkative chattering incoherently.

Types of Types of SchizophreniaSchizophrenia

Paranoid TypeParanoid TypePreoccupied with one or more sets of bizarre delusions (of grandeur or persecution), often based on the “out to get me” attitude. Is extremely suspicious. Nothing makes sense.

ResidualResidualOriginally called simple schizophrenia. Characterized by withdrawal, minimal emotional responding, absence of motivation.

Types of Types of SchizophreniaSchizophrenia

Undifferentiated Undifferentiated TypeTypeHas many symptoms (e.g. delusions, hallucinations, and incoherence) but doesn’t fit neatly into any specific category.

Causes of Causes of SchizophreniaSchizophrenia

• EnvironmentExposure to influenza or rubella virus during pregnancy Malnutrition during pregnancyComplications during birthEarly Psychological TraumaDisturbed Family EnvironmentStressful relationships

Negative emotions

Deviant Communicatons Patterns

• GeneticsSome individuals inherit a potential for developing schizophrenia Makes them more vulnerable to the disorderEvidence from twin studies

• Brain ChemistryAbuse of some drugs produces symptoms similar to schizophreniaDopamine overactivity in brain may be related to schizophreniaGlutamate may also be related

Schizophrenia:Schizophrenia:Stress-Vulnerability HypothesisStress-Vulnerability Hypothesis

• Psychotic disorders Psychotic disorders result from result from combination of combination of environmental environmental stress and stress and inherited inherited susceptibilitysusceptibility

The Mood The Mood DisordersDisorders

DepressionDepressed mood, motor retardation, uneasiness & apprehension, intense dejection, self-depreciation, self-condemnation, guilt which can become delusional.Types of DepressionClinicalClinical or endogenous depressionPsychologicalPsychological or exogenous depressionMajor Depression vs. DysthymiaMajor depression is an intense sadness that lasts for months.Dysthymia is a less intenseless intense sadness with little relief for at least 2 years.

The Mood The Mood DisordersDisorders

SuicideSuicide30,000 people per year in the U.S.A. commit suicide.More women attempt suicide, but more men commit it.Men take more active means.Stress is often involved in suicides.Leaving home, college, career, broken romance, unemployment, financial strain are major reasons.The person tends to be overwhelmed with hopelessness.

The Mood The Mood DisordersDisorders

ManiaManiaThe opposite of depression.The opposite of depression.Overtalkativeness, heightened motor activity, Overtalkativeness, heightened motor activity, flight of ideas, extreme elation.flight of ideas, extreme elation.

2 types of mania:2 types of mania:Hypomania – a mild form of mania– a mild form of maniaAcute mania – boastfulness, expansive, – boastfulness, expansive, unrealistic, ambitious, boisterousness & violent.unrealistic, ambitious, boisterousness & violent.

The Causes of Mood The Causes of Mood DisordersDisordersBiological causeBiological causeGenetics & biochemistryGenetics & biochemistryPsychological causePsychological causeCognitive distortions of the environmentCognitive distortions of the environmentSocial causeSocial causeInterpersonal problemsInterpersonal problems

Major Mood Disorders

• Bipolar Disorders – Bipolar I Disorder

• Extreme mania and deep depression

• Mania– Excited, hyperactive, energetic, loud, grandiose behavior

– Bipolar II Disorder • Person is mainly sad but has one or more hypomanic episodes

(mild mania)

Causes of Mood Disorders

• Seasonal Affective Disorder (SAD)– Depression that

only occurs during fall and winter.

• More common in Northern latitudes

• May be related to reduced exposure to sunlight

• Phototherapy: Extended exposure to bright light to treat SAD

Anxiety DisordersAnxiety DisordersAnxiety is a condition in which intense feelings of fear & dread are long standing or disruptive.5 types of anxiety disordersPhobiasGeneralized Anxiety Disorder (GAD)Panic Disorder (PD)Obsessive-Compulsive Disorder (OCD)Posttraumatic Stress Disorder (PTSD)

PhobiasPhobiasOut-of-proportion fears associated with circumstances & objects.Most common phobias:Social phobiasFears associated with social situations (e.g. agoraphobia)Object phobiasFears associated with dogs, cats, spiders, etc.Event phobiasFears associated with something happening (e.g. fear of being struck by lightning, being hit by a meteor or asteroid, stepping on the cracks in a sidewalk, etc.)

Panic DisordersPanic DisordersRecurring attacks of Recurring attacks of panic, periods of panic, periods of intense fear, & intense fear, & feelings of feelings of impending doom or impending doom or death accompanied death accompanied by physiological by physiological symptoms all symptoms all occurring without occurring without cause.cause.Often seen with a phobic response.Feelings of dizziness, problems with breathing, sweating, & trembling.After an attack, the fear of another panic attack sets in.

Other Anxiety DisordersOther Anxiety Disorders

Generalized Anxiety Generalized Anxiety DisorderDisorderProlonged, unfocused, Prolonged, unfocused, intense fear response.intense fear response.Not attached to any object Not attached to any object or eventor event

Obsessive-Compulsive Obsessive-Compulsive DisorderDisorderPersistent, intrusion of Persistent, intrusion of unwanted thoughts, urges, unwanted thoughts, urges, or actions that are unable or actions that are unable to stop.to stop.Includes the “pack-rat”Includes the “pack-rat”

Other Anxiety DisordersOther Anxiety Disorders

PosttraumaPosttraumatic Stress tic Stress DisorderDisorderAn anxiety disorder in which a person who has experienced a traumatic or life-threatening event has symptoms such as psychic numbing, reliving of the trauma, & increased physiological arousal.

Causes of Anxiety DisordersCauses of Anxiety DisordersDepends on the pointDepends on the point of viewof view1. Learned1. LearnedEither directly or vicariouslyLocus of control seen outside.2. Biological2. BiologicalGenetic predispositions.3. Psychological3. PsychologicalInternal conflicts produce anxiety.Follow this with extensive use of the defense mechanisms.

Psychosomatic & Somatoform Psychosomatic & Somatoform DisordersDisorders

Psychosomatic Psychosomatic DisordersDisordersPsychological factors produce real Psychological factors produce real physical disorders.physical disorders.Stress is strongly indicatedStress is strongly indicated..

Somatoform Somatoform DisordersDisordersPhysical symptoms persist without Physical symptoms persist without any identifiable physical cause.any identifiable physical cause.Conversion DisordersHypochondriasisBody Dysmorphic Disorder

Dissociative Dissociative DisordersDisorders

Some aspect of the personality seems to be separated from the rest.

• Dissociative AmnesiaDissociative AmnesiaA loss of memory with no organic cause.Usually after a stressful event.Usually accompanied by a Dissociative Fugue.

• Dissociative Identity Dissociative Identity DisorderDisorderMultiple Personality DisorderSeveral distinct personalities in the same person.

• Depersonalization DisorderDepersonalization DisorderFeelings of being changed or different in a strange way.

Sexual & Gender-Identity DisordersSexual & Gender-Identity Disorders

Sexual Sexual DysfunctionDysfunctionErectile DisorderErectile DisorderThe inability to achieve or The inability to achieve or maintain an erectionmaintain an erectionPhysical or Psychological causesPhysical or Psychological causes

Female Sexual Female Sexual Arousal DisorderArousal DisorderThe inability to become excited The inability to become excited or achieve orgasmor achieve orgasmAbout 1/3 have genetic construct, About 1/3 have genetic construct, others are psychologicalothers are psychological

Sexual DisordersSexual DisordersParaphiliasParaphiliasExhibitionismExhibitionismExposure of one’s genitals to an Exposure of one’s genitals to an unsuspecting stranger.unsuspecting stranger.

VoyeurismVoyeurismObserving a stranger naked, etc.Observing a stranger naked, etc.

FetishismFetishismSexual arousal from nonliving Sexual arousal from nonliving objects.objects.

Transvestic FetishismTransvestic FetishismDressing in clothing of the opposite Dressing in clothing of the opposite sex.sex.

Sexual DisordersSexual DisordersSadism & MasochismSadism & Masochism

Arousal from dominating or being Arousal from dominating or being dominated.dominated.

FrotteurismFrotteurism

Touching or rubbing against a non-Touching or rubbing against a non-consenting person.consenting person.

NecrophiliaNecrophilia

Obsession with dead bodies.Obsession with dead bodies.

KlismaphiliaKlismaphilia

Sexual excitement from enemas.Sexual excitement from enemas.

CoprophiliaCoprophilia

Arousal through feces.Arousal through feces.

ZoophiliaZoophilia

Sexual activity with animals.Sexual activity with animals.

Gender-Identity Disorder

The desire to become or the insistence one The desire to become or the insistence one is the opposite sex.is the opposite sex.Transsexuals & certain transvestitesTranssexuals & certain transvestites

In children it is seen as boys playing with girls toys and girls playing with boys toys.In children it is seen as boys playing with girls toys and girls playing with boys toys.