John Thomas

Chapter 16: Psychological Disorders

• Perspectives on Psychological Disorders

o Psychological disorders fascinate us, partly because most of us will at
some time experience or witness them close at hand.
• Defining Psychological Disorders
o Between normality and abnormality there is not a gulf but a somewhat
arbitrary line.
o Where we draw this line depends on how atypical, disturbing,
maladaptive, and unjustifiable a person’s behavior is.
• Understanding Psychological Disorders
o The medical model’s assumption that psychological disorders are mental
illnesses displaced earlier views that demons and evil spirits were to
blame.
o However, critics question the medical model’s
 labeling of psychological disorders as sicknesses.
o Most mental health workers today adapt a biopsychosocial perspective.
 They assume that disorders are influenced by
• genetic predisposition
• physiological states
• psychological dynamics
• social circumstances.
• Classifying Psychological Disorders
o Naming and describing psychological disorders in treatment and research.
 Many psychiatrists and psychologists use the American Psychiatric
Association’s Diagnostic
 Statistical Manual of Mental Disorders (DSM-IV)
o Most health insurance policies in North America require DSM-IV
diagnoses before they will pay for therapy.
• Labeling Psychological Disorders
• Critics point out the price we pay for these benefits of classifying disorders:
o Labels also can create preconceptions that
 Unfairly stigmatize people and bias our perceptions of their past
and present behavior.
• Anxiety Disorders
o Anxiety is part of our everyday experience.
o It is classified as a psychological disorder only when
 it becomes distressing or persistent or is characterized by
maladaptive behaviors intended to reduce it.
• Generalized Anxiety Disorder and Panic Disorder
o Those who suffer generalized anxiety disorder may for no clear reason
feel persistently and uncontrollably tense and uneasy.
o Anxiety escalates into periodic episodes of intense dread for those
suffering panic disorder.
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• Phobias
o Those with a phobic disorder may be irrationally afraid of a specific object
or situation.
o The fear can disrupt behavior and lead to incapacitating efforts to avoid
the situation or object.
• Obsessive-Compulsive Disorder
o Persistent and repetitive thoughts and actions characterize obsessive-
compulsive disorder.
 The thoughts and behaviors are so persistent that they interfere
with daily living and cause the person distress.
• Post-Traumatic Stress Disorder
o Experiencing a traumatic event can lead to this disorder.
o The symptoms are
 four or more weeks of memories
 nightmares
 social withdrawal
 jumpy anxiety
 Sleep problems.
• Explaining Anxiety Disorders
o The psychoanalytic perspective viewed anxiety disorders as the
discharging of repressed impulses.
o Psychologists now tend to consider these disorders from the learning and
biological perspectives.
 The learning perspective sees anxiety disorders as a product of fear
conditioning, stimulus generalization, reinforcement, and
observational learning.
 The biological perspective considers possible evolutionary,
genetic, and physiological influences.
• Mood Disorders
o Mood disorders are characterized by emotional extremes. The two
principal forms are major depressive disorder and bipolar disorder.
• Major Depressive Disorder
o In major depression, the person—without apparent reason—descends for
weeks or months into
 Deep unhappiness
 Lethargy
 Feelings of worthlessness before rebounding to normality.
o Although less disabling, dysthymic disorder is marked by chronic low
energy and poor self-esteem.
• Bipolar Disorder
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o In the less common bipolar disorder, the person alternates between the
hopelessness and lethargy of depression and the hyperactive, wildly
optimistic, impulsive phase of mania.
• Explaining Mood Disorders
o Current research on depression is vigorously exploring two sets of
influences.
 The first focuses on genetic predispositions and neurotransmitter
abnormalities.
 The second views the cycle of depression from a social-cognitive
perspective, in light of cyclic self-defeating beliefs, learned
helplessness, negative attributions, and aversive experiences.
• Schizophrenia
o Schizophrenia typically strikes during late adolescence. It affects men and
women about equally, and it seems to occur in all cultures.
• Symptoms of Schizophrenia
o Schizophrenia shows itself in disorganized thinking (nonsensical talk and
delusions, which may stem from a breakdown of selective attention)
 Disturbed perceptions (including hallucinations)
 Inappropriate emotions and actions. It is rarely a one-time episode.
• Subtypes of Schizophrenia
o Schizophrenia is a set of disorders that emerges either gradually from a
chronic history of social inadequacy (in which case the outlook is dim) or
suddenly in reaction to stress (in which case the prospects for recovery are
brighter).
• Understanding Schizophrenia
o Multiple factors converge to create schizophrenia.
o As they have for depression, researchers have linked certain forms of
schizophrenia with brain abnormalities
 In this case, with enlarged, fluid-filled cerebral cavities or
increased receptors for the neurotransmitter dopamine, known to
be a major player in schizophrenia.
o Twin and adoption studies also point to a genetic predisposition that, in
conjunction with environmental factors, may bring about a schizophrenia
disorder.
• Personality Disorders

• Antisocial Personality Disorder

o Personality disorders are enduring, maladaptive patterns of behavior that
impair social functioning.
o A person with antisocial personality (typically a male who displays a lack
of conscience before age 15) can be violent or a charming con artist.
• Understanding Antisocial Personality Disorder
o Both genetics and environment influence Antisocial Personality Disorder.
o People with the disorder have reduced activity in the frontal lobe, an area
of the cortex.
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o They may also be more sensitive to maltreatment as children.