Chapter 14: Psychological Disorders

Abnormal Behavior

• What is abnormal behavior?– Deviant– Maladaptive – Causing personal distress– NOT culturally bound

• Normal/abnormal is a continuum

Prevalence, Causes, and Course

• Epidemiology – Study of mental disorders• Prevalence – % of population that has

disorder• Lifetime prevalence - % of population that will

have a disorder at sometime in their lives• Diagnosis• Etiology – Apparent causation • Prognosis – Forecast about outcome of

treatment

Figure 14.5 Lifetime prevalence of psychological disorders

Psychodiagnosis:The Classification of Disorders

• American Psychiatric Association• Diagnostic and Statistical Manual of Mental

Disorders – 4th ed. (DSM - 4)• Five Axis

• Axis I – Clinical Syndromes• Axis II – Personality Disorders or Mental

Retardation• Axis III – General Medical Conditions• Axis IV – Psychosocial and Environmental

Problems• Axis V – Global Assessment of

Functioning (1-100)

Axis I Clinical Syndromes

• Anxiety Disorders• Somatoform Disorders• Dissociative Disorders• Mood Disorders• Schizophrenic Disorders

Clinical Syndromes: Anxiety Disorders

• Generalized anxiety disorder– “free-floating anxiety”

• Phobic disorder– Specific focus of fear

• Panic disorder and agoraphobia• Obsessive compulsive disorder

– Obsessions– Compulsions

• Posttraumatic Stress Disorder

Etiology of Anxiety Disorders• Biological factors

– Genetic predisposition, anxiety sensitivity– GABA circuits in the brain– Seretonin Abnormalities for OCD and

PTSD• Conditioning and learning

– Acquired through classical conditioning, maintained through operant conditioning

• Cognitive factors– Judgments of perceived threat

• Personality– Neuroticism

Figure 14.7 Conditioning as an explanation for phobias

Clinical Syndromes: Mood Disorders

• Major depressive disorder– Dysthymic disorder (Depression not yet

MDD)– More common in females

• Bipolar disorder– Cyclothymic disorder (exhibit chronic but

relatively mild symptoms of bipolar disturbance)

• Etiology – Biological: abonormal levels of

norepinephrine and serotonin synapses – Cognitive: Negative thinking

Figure 14.11 Episodic patterns in mood disorders

Figure 14.13 Twin studies of mood disorders

Clinical Syndromes: Somatoform Disorders

• Somatization Disorder – complaints about vague problems

• Conversion Disorder – Displaying loss of physical function without organic cause

• Hypochondriasis – Excessive worry about one’s health.

Figure 14.10 Glove anesthesia

Clinical Syndromes: Dissociative Disorders

• Dissociative amnesia• Dissociative fugue• Dissociative identity disorder

– Etiology• severe emotional trauma during

childhood– Controversy

• Media creation?

Clinical Syndromes: Schizophrenia

• General symptoms– Delusions and irrational thought– Deterioration of adaptive behavior– Hallucinations– Disturbed emotions

• Prognostic factors: best if diagnosed later in life with good social support structure

Subtyping of Schizophrenia

• 4 subtypes– Paranoid type: Delusions of persecution

and/or grandeur– Catatonic type: Muscular rigidity and/or

random motor activity– Disorganized type: Withdrawn, focuses

solely on self– Undifferentiated type

• Positive vs. negative symptoms

Etiology of Schizophrenia

• Genetic vulnerability• Neurochemical factors

– Perhaps abnormal levels of dopamine or serotonin

• Precipitating stress– diathesis-stress model

Figure 14.18 The dopamine hypothesis as an explanation for schizophrenia

Figure 14.20 The neurodevelopmental hypothesis of schizophrenia

Personality Disorders

• Anxious-fearful cluster– Avoidant, dependent, obsessive-

compulsive• Dramatic-impulsive cluster

– Histrionic, narcissistic, borderline, antisocial

• Odd-eccentric cluster– Schizoid, schizotypal, paranoid

• Etiology– Genetic predispositions, inadequate

socialization in dysfunctional families

Table 14.2 Personality Disorders

Developmental Disorders

• Autism– Social impairment– Restrictive and repetitive behaviors

• Asperger’s – On the autism spectrum– Not withdrawn, but have poor social skills– Usually take interest in specific things

• ADHD– Attention Deficit

• Has difficulty concentrating and staying on task– Hyperactivity

• Usually restless and impulsive

Psychological Disorders and the Law

• Insanity– M’naghten rule

• Involuntary commitment– danger to self– danger to others– in need of treatment

Figure 14.22 The insanity defense: public perceptions and actual realities