Chapter 14: Psychological Disorders
Chapter Summary

I.STUDYING PSYCHOLOGICAL DISORDERS

A.Identifying Abnormal Behavior - Abnormal behavior is identified as patterns of emotion, thought, and action considered pathological for one or more or the following criteria: statistical infrequency, disability or dysfunction, personal distress, or violation of norms. The limitations of each criteria are reviewed and the term insanity is explored.

Gender and Cultural Diversity: Avoiding Ethnocentrism - Culture-bound disorders (such as "windigo psychosis") are unique and found only in specific cultures. This section compares several culture-bound and culture-general disorders.

B.Explaining Abnormality - The belief that demons cause abnormal behavior was common in ancient times. The medical model, which emphasizes disease and illness, replaced this demonological model. During the Middle Ages, demonology returned and exorcisms were used to treat abnormal behavior. Asylums began to appear toward the close of the Middle Ages as Pinel’s medical model gave rise to the modern specialty of psychiatry.

Critics of the medical model often use psychological perspectives, which emphasize unconscious conflicts, inappropriate learning, faulty cognitive processes, and negative self-concepts in the development of abnormal behavior. Modern biological theories emphasize physiological causes for problem behaviors. Rosenhan’s famous study illustrates problems with diagnostic labeling.

C.Classifying Abnormal Behavior - The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) categorizes disorders and provides detailed descriptions useful for communication among professionals. Although an adequate diagnosis is needed for proper treatment, labels can also become self-fulfilling. Furthermore, the DSM has been criticized for ignoring cultural factors and for continuing to support the medical model. The current DSM-IV-TR is organized according to five major dimensions, called axes, which are guidelines for making decisions about symptoms.

II.ANXIETY DISORDER

A.Four Major Anxiety Disorders - People with anxiety disorders have persistent feelings of threat that are unreasonable and often paralyzing. In generalized anxiety disorders, there is a persistent free-floating anxiety. In panic disorder, fear or discomfort arises abruptly and peaks in 10 minutes or less. Phobias are exaggerated fears of specific objects or situations, such as agoraphobia, a fear of being in open spaces. In obsessive-compulsive disorder, persistent anxiety-arousing thoughts (obsessions) are relieved by ritualistic actions (compulsions) such as hand-washing. In posttraumatic stress disorder (PTSD), a person who has experienced an overwhelming trauma, such as rape, has recurrent maladaptive emotional reactions, such as exaggerated startle responses, sleep disturbances, and flashbacks.

B.Explaining Anxiety Disorders - Research on the causes of anxiety disorders have focused on cognitive processes, learning, biology, and sociocultural influences. The cognitive approach emphasizes thinking styles, such as, hypervigilance, hypersensitivity, and self-preoccupation that magnifies ordinary threats and failures, resulting in anxiety disorders. Learning theorists suggest anxiety disorders result from classical and operant conditioning, as well as modeling and imitation. The biological perspective suggests that genetic pre-dispositions, disrupted biochemistry, or unusual brain activity influence the development of anxiety disorders.

III.MOOD DISORDERS

A.Understanding Mood Disorders - Mood disorders are characterized by extreme disturbances of emotional states. The hallmark of major depressive disorder is a pervasive feeling of deep sadness which interferes with basic ability to function, feel pleasure, or maintain interest in life. Bipolar disorder is characterized by episodes similar to major depressive disorder alternating with episodes of mania in which speech and thinking are rapid, and the person may experience delusions of grandeur and engage in impulsive behaviors.

Gender and Cultural Diversity: How They Affect Depression – Research shows certain symptoms of depression are cross-cultural. Women are more likely than men to suffer depressive symptoms in many countries. Some researchers explain this in terms of hormonal differences, while others propose that cultural factors (such as poverty and discrimination) and socialization toward certain behaviors (such as passivity and dependence may predispose women toward depression.

B.Explaining Mood Disorders - Biological theories of mood disorders indicate areas of the left prefrontal cortex lobe may be involved. Other research emphasizes disruptions in neurotransmitters (especially norepinephrine and serotonin). Antidepressants are often effective in relieving major depression. Bipolar disorders are generally treated with lithium carbonate. Recent research has also implicated certain brain areas that may trigger episodes of mood disorder. There is also evidence for a genetic predisposition for both major depression and bipolar disorder. The evolutionary perspective suggests moderate depression may be an adaptive response to a loss. Psychosocial theories of mood disorders emphasize disturbed interpersonal relationships, thought processes, poor self-concept, and learning history. Learned helplessness theory suggests that depression results from repeated failures at attempted escape from the source of stress. Depression also has been shown to be related to seasons of the year. Most seasonal affective disorder (SAD) sufferers report problems with depression in the winter. Studies with controlled periods of light have been effective in relieving this type of depression.

Research Highlight: Suicide and Its Prevention - Suicide is a serious problem associated with mood disorders. Students are asked to respond to a questionnaire containing ten true/false statements regarding suicide. Major warning signs of suicide are reviewed.

Critical Thinking/Active Learning: How Your Thoughts Can Make You Depressed – Students are presented with two situations which provide anopportunity to think about how thoughts may cause mild to serious depression.

IV.SCHIZOPHRENIA - Schizophrenia is a serious psychotic mental disorder that afflicts approximately one out of every 100 people.

A.Symptoms of Schizophrenia - The major symptoms are disturbances in perception (impairedfiltering and selection, and hallucinations); language and thought disturbances (impaired logic, word salads, neologisms, and delusions); emotional disturbances (either exaggerated or blunted emotions); and behavioral disturbances (social withdrawal, bizarre mannerisms, catalepsy, waxy flexibility).

B.Types of Schizophrenia – For many years, researchers have divided the schizophrenias into paranoid, catatonic, disorganized, undifferentiated, and residual subtypes. An alternative classification system has been proposed. Schizophrenic symptoms involving distorted or excessive mental activity (e.g., delusions and hallucinations) would be classified as positive symptoms, whereas symptoms involving behavioral deficits (e.g., toneless voice, flattened emotions) would be classified as negative symptoms.

C.Explaining Schizophrenia - Biological theories of the causes of schizophrenia emphasize genetics (people inherit a predisposition), disruptions in neurotransmitters (primarily dopamine), and abnormalities in brain structure or function (such as enlarged ventricles or low levels of activity in the frontal and temporal lobes).

Psychosocial theories of schizophrenia focus on stress as a trigger for initial episodes and for relapse. Family communication deviance also has been suggested. Studies of family environments suggest that high expressed emotionality may be linked to a worsening and relapse of schizophrenic symptoms.

An evaluation of the theories of the causes of schizophrenia get mixed research support. Biological theories cannot necessarily determine the direction of cause and effect relationships. Psychosocial theories have been unable to exactly determine how and why certain life events trigger schizophrenic episodes in some cases, but not in others. Overall, schizophrenia is probably a combination of interacting (known and unknown) factors. Table 14.2 provides a summary of the main categories of mental disorders and their descriptions.

Gender and Cultural Diversity: Schizophrenia Around the World - Schizophrenia is the most culturally universal mental disorder in the world. There are numerous culturally general symptoms (such as delusions), but also four major differences across cultures: prevalence, form, onset, and prognosis.

V.OTHER DISORDERS

Substance-Related Disorders – The criteria for substance use and substance abuse are explored. Alcohol Use Disorders (AUDs) are at a greater risk of also experiencing at least one or more other mental disorders known as comorbidity, or dual diagnosis. Genetic predisposition, modeling by the parent, and/or emotional disturbances are cited as possible causes of substance-related disorders.

A.Dissociative Disorders - In dissociative disorders, critical elements of personality split apart from significant aspects of experience, memory, or consciousness. This split is manifested by failing to recall or identify past experiences (dissociative amnesia), by leaving home and wandering off (dissociative fugue), or by developing completely separate personalities (dissociative identity disorder [DID] or multiple personality disorder). There is considerable debate over this diagnosis.

B.Personality Disorders - Personality disorders involve inflexible, maladaptive personality traits. The best known type is the antisocial personality, characterized by egocentrism, lack of conscience, impulsivity, and superficial charm. Some research has suggested this disorder may be related to defect in brain waves and arousal patterns, genetic inheritance, and disturbed family relationships. The most commonly diagnosed personality disorder is the Borderline Personality Disorder. The core features include impulsivity, instability in mood, relationships, and self-image. A childhood history of neglect, emotional deprivation, and physical, sexual, or emotional abuse are frequently associated with BPD.

Applying Psychology to Student Life: Testing Your Knowledge of Abnormal Behavior – The student is asked test their recognition of five psychological disorders and match with a brief description.