Psychological DisordersPsychological Disorders

Normal or Not?Normal or Not? Story: A man living in the Ozark Story: A man living in the Ozark

Mountains has a vision in which God Mountains has a vision in which God speaks to him. He begins preaching to speaks to him. He begins preaching to his relatives and neighbors, and soon has his relatives and neighbors, and soon has the entire town in a state of religious the entire town in a state of religious panic. People begin to say that he has a panic. People begin to say that he has a “calling.” His reputation as a prophet and “calling.” His reputation as a prophet and a healer spreads, and in time he is a healer spreads, and in time he is drawing large audiences wherever he drawing large audiences wherever he goes. goes.

However, when he ventures in St. Louis However, when he ventures in St. Louis ad attempts to hold a prayer meeting, ad attempts to hold a prayer meeting, blocking traffic on main street at rush blocking traffic on main street at rush hour, he Is arrested. He tells the hour, he Is arrested. He tells the policemen about his conversations with policemen about his conversations with God, and they hurry him off to the nearest God, and they hurry him off to the nearest mental hospital.mental hospital.

Normal or not?Normal or not? Who is right…The man who Who is right…The man who

believes he is a prophet, or the believes he is a prophet, or the police officers?police officers?

It Is often difficult to draw a line It Is often difficult to draw a line between normal and abnormal between normal and abnormal behavior.behavior.

Behavior that some consider to be Behavior that some consider to be normal seems abnormal to others.normal seems abnormal to others.

Many people believe that having Many people believe that having visions and hearing voices are visions and hearing voices are important parts of a religious important parts of a religious experience.experience.

Other people believe that these are Other people believe that these are symptoms of a psychological symptoms of a psychological disorder.disorder.

Normal or Not?Normal or Not?

The man in the example on the The man in the example on the previous slide was interviewed previous slide was interviewed by psychiatrists, diagnosed as by psychiatrists, diagnosed as paranoid schizophrenic, and paranoid schizophrenic, and hospitalized.hospitalized.

Had he stayed at home, people Had he stayed at home, people would have continued to see would have continued to see him as perfectly normal – even him as perfectly normal – even popular…popular…

Defining and Identifying Psychological DisordersDefining and Identifying Psychological Disorders

In the previous example, the In the previous example, the man was classified as mentally man was classified as mentally troubled because his behavior troubled because his behavior was so different from what was so different from what others felt was normal under others felt was normal under the circumstances.the circumstances.

Yet, the fact that a person is Yet, the fact that a person is different does not necessarily different does not necessarily mean that he or she is suffering mean that he or she is suffering from a mental illness.from a mental illness.

Deviation from NormalityDeviation from Normality

One approach to One approach to defining abnormality defining abnormality is to say that is to say that whatever most whatever most people do is normal.people do is normal.

Abnormality, then, Abnormality, then, would be any would be any deviation from the deviation from the average or from the average or from the majority.majority.

Deviation from NormalityDeviation from Normality The deviance approach, The deviance approach,

however, as commonly used however, as commonly used as it is, has serious as it is, has serious limitations.limitations.

For example: If most people For example: If most people cheat on their income-tax cheat on their income-tax returns, does that mean that returns, does that mean that the people who do not cheat the people who do not cheat are abnormal?are abnormal?

Because the majority is not Because the majority is not always right or best, the always right or best, the deviance approach to deviance approach to defining abnormality is not by defining abnormality is not by itself a useful standard.itself a useful standard.

AdjustmentAdjustment Another way to distinguish Another way to distinguish

normal from abnormal normal from abnormal people is to say that normal people is to say that normal people are able to get along people are able to get along in the world – physically, in the world – physically, emotionally, and socially.emotionally, and socially.

Basically, people who live Basically, people who live by the rules of society.by the rules of society.

By this definition, abnormal By this definition, abnormal people would be the ones people would be the ones who fail to adjust to society.who fail to adjust to society.

What do you think?What do you think?

So what is right? So what is right? Who is to say what Who is to say what

issues constitute a issues constitute a psychological psychological disorder, and what disorder, and what issues are merely issues are merely minor variations from minor variations from what is considered to what is considered to be normal behavior?be normal behavior?

Anxiety DisordersAnxiety Disorders Anxiety:Anxiety: is a general state of is a general state of

dread or uneasiness that a dread or uneasiness that a person feels in response to a person feels in response to a real or imagined danger.real or imagined danger.

People suffering from anxiety People suffering from anxiety disorders feel anxiety, but not disorders feel anxiety, but not just normal anxiety.just normal anxiety.

They suffer from anxiety that is They suffer from anxiety that is out of proportion to the situation out of proportion to the situation that is provoking it.that is provoking it.

This intense anxiety may This intense anxiety may interfere with the normal interfere with the normal functioning of everyday life.functioning of everyday life.

Anxiety disorders are the most Anxiety disorders are the most common mental disorders in the common mental disorders in the United States.United States.

Anxiety DisordersAnxiety Disorders These disorders share certain These disorders share certain

characteristics, including feelings of characteristics, including feelings of anxiety and personal inadequacy and anxiety and personal inadequacy and an avoidance of dealing with an avoidance of dealing with problems.problems.

People with anxiety disorders often People with anxiety disorders often have unrealistic images of have unrealistic images of themselves.themselves.

Their emotional problems may be Their emotional problems may be expressed with constant worrying, expressed with constant worrying, sudden mood swings, or a variety of sudden mood swings, or a variety of physical symptoms (headaches, physical symptoms (headaches, sweating, muscle tightness, sweating, muscle tightness, weakness, and fatigue.)weakness, and fatigue.)

These people often have difficulty These people often have difficulty forming and sustaining long term forming and sustaining long term relationships.relationships.

Why do you think this is?Why do you think this is?

Phobia DisorderPhobia Disorder Phobia:Phobia: An intense or irrational fear An intense or irrational fear

of an object or situation.of an object or situation. Phobias range in intensity from mild Phobias range in intensity from mild

to extremely severe.to extremely severe. Most people deal with phobias by Most people deal with phobias by

simply avoiding what frightens simply avoiding what frightens them.them.

Thus, phobias are learned and Thus, phobias are learned and maintained by reinforcing the maintained by reinforcing the effects of avoidance, which reduces effects of avoidance, which reduces anxiety but not the phobia.anxiety but not the phobia.

Example: If you are afraid of Example: If you are afraid of spiders, you do your best to avoid spiders, you do your best to avoid them at all costs.them at all costs.

Panic DisorderPanic Disorder Panic Disorder:Panic Disorder: An extreme anxiety An extreme anxiety

that manifests itself in the form of that manifests itself in the form of panic attacks.panic attacks.

During a panic attack, a victim During a panic attack, a victim experiences sudden and experiences sudden and unexplainable attacks of intense unexplainable attacks of intense anxiety, leading the individual to feel anxiety, leading the individual to feel a sense of inevitable doom or even a sense of inevitable doom or even the fear that he or she is about to die.the fear that he or she is about to die.

Many symptoms of panic disorder Many symptoms of panic disorder include; an extreme sense of include; an extreme sense of smothering, choking, difficulty smothering, choking, difficulty breathing, fainting, dizziness, nausea, breathing, fainting, dizziness, nausea, and chest pains.and chest pains.

Panic DisorderPanic Disorder Although panic attacks Although panic attacks

sometimes last for an sometimes last for an hour or more, most hour or more, most attacks last only a few attacks last only a few minutes and come on minutes and come on without warning.without warning.

Panic disorder may be Panic disorder may be inherited.inherited.

However, the panic victim However, the panic victim usually experiences their usually experiences their first attacks shortly after a first attacks shortly after a stressful event.stressful event.

Post Traumatic Stress DisorderPost Traumatic Stress Disorder Post-Traumatic Stress Disorder:Post-Traumatic Stress Disorder: A A

disorder in which victims of traumatic disorder in which victims of traumatic events experience the original event in events experience the original event in the form of dreams or flashbacks.the form of dreams or flashbacks.

This disorder is common among veterans This disorder is common among veterans of military combat and survivors of acts of of military combat and survivors of acts of terrorism, natural disasters such as floods terrorism, natural disasters such as floods or tornadoes, other catastrophes such as or tornadoes, other catastrophes such as a plane crash, and human aggression a plane crash, and human aggression such as rape or assault.such as rape or assault.

The event that triggers the disorder The event that triggers the disorder overwhelms a person’s sense of reality overwhelms a person’s sense of reality and ability to cope.and ability to cope.

This disorder may begin shortly after a This disorder may begin shortly after a traumatic experience or it may develop traumatic experience or it may develop much later.much later.

Post-Traumatic Stress DisorderPost-Traumatic Stress Disorder Typical symptoms include involuntary Typical symptoms include involuntary

flashbacks and recurring nightmares flashbacks and recurring nightmares during which the victim re-during which the victim re-experiences the ordeal, often experiences the ordeal, often followed by insomnia or feelings of followed by insomnia or feelings of guilt.guilt.

Post-Traumatic Stress Disorder can Post-Traumatic Stress Disorder can be extremely long lasting.be extremely long lasting.

Survivors of the holocaust, veterans Survivors of the holocaust, veterans of the Vietnam war, and survivors of of the Vietnam war, and survivors of the attacks on Pearl Harbor may still the attacks on Pearl Harbor may still display symptoms of this disorder.display symptoms of this disorder.

Not everyone though, who Not everyone though, who experiences a traumatic event will experiences a traumatic event will develop this disorder.develop this disorder.

Somatoform DisorderSomatoform Disorder Somatoform Disorder:Somatoform Disorder:

Physical symptoms for Physical symptoms for which there is no which there is no apparent physical cause.apparent physical cause.

Somatoform is also Somatoform is also commonly known as commonly known as HysteriaHysteria..

The term hysteria was The term hysteria was more commonly used in more commonly used in Sigmund Freud’s time.Sigmund Freud’s time.

It was used to refer to It was used to refer to unexplainable fainting, unexplainable fainting, paralysis, or deafness.paralysis, or deafness.

Somatoforms DisorderSomatoforms Disorder There are 2 major types of Somatoform There are 2 major types of Somatoform

Disorder…Conversion Disorder and Disorder…Conversion Disorder and Hypochondriasis.Hypochondriasis.

Conversion Disorder:Conversion Disorder: Changing emotional Changing emotional difficulties into a loss of a specific voluntary difficulties into a loss of a specific voluntary body function.body function.

While the loss of functioning is completely While the loss of functioning is completely real, no physical damage is present.real, no physical damage is present.

Many people occasionally experience mild Many people occasionally experience mild conversion disorders, such as when a conversion disorders, such as when a person is frightened and cannot move, but person is frightened and cannot move, but true conversion disorder is not simply a brief true conversion disorder is not simply a brief loss of functioning due to fright…It persists.loss of functioning due to fright…It persists.

Conversion DisorderConversion Disorder A conversion disorder results in a A conversion disorder results in a

real and prolonged handicap; the real and prolonged handicap; the person literally cannot feel his left person literally cannot feel his left hand, move his legs, or exercise hand, move his legs, or exercise some other normal physical function.some other normal physical function.

For example; a man might wake up in For example; a man might wake up in the morning and not be able to feel the morning and not be able to feel anything from the waist down, finding anything from the waist down, finding himself paralyzed. himself paralyzed.

The normal reaction to this would be The normal reaction to this would be one of panic. However, he may one of panic. However, he may simply accept this, showing that it is simply accept this, showing that it is more of a psychological problem than more of a psychological problem than a physical one.a physical one.

HypochondriasisHypochondriasis Hypochondriasis:Hypochondriasis: A disorder in A disorder in

which a person who is in good which a person who is in good health becomes preoccupied with health becomes preoccupied with imaginary ailments.imaginary ailments.

The hypochondriac spends a lot of The hypochondriac spends a lot of time looking for signs of serious time looking for signs of serious illness and often misinterprets minor illness and often misinterprets minor aches, pains, bruises, or bumps as aches, pains, bruises, or bumps as signs of a fatal illness.signs of a fatal illness.

Despite negative results in medical Despite negative results in medical tests and physical evaluations, the tests and physical evaluations, the hypochondriac typically continues to hypochondriac typically continues to believe that a disease or believe that a disease or malfunction exists.malfunction exists.

Dissociative DisordersDissociative Disorders Dissociative Disorder:Dissociative Disorder: A disorder in A disorder in

which a person experiences which a person experiences alterations in memory, identity, or alterations in memory, identity, or consciousness.consciousness.

There are many different types of this There are many different types of this disorder.disorder.

1. Dissociative Amnesia:1. Dissociative Amnesia: The The inability to recall important personal inability to recall important personal events or information; is usually events or information; is usually associated with stressful events.associated with stressful events.

Amnesiacs remember how to speak Amnesiacs remember how to speak and usually retain some general and usually retain some general knowledge, but may forget who they knowledge, but may forget who they are, where they live and work, or who are, where they live and work, or who their family is.their family is.

Dissociative DisordersDissociative Disorders 2. Dissociative Fugue:2. Dissociative Fugue: A dissociative disorder A dissociative disorder

in which a person suddenly and unexpectedly in which a person suddenly and unexpectedly travels away from home or work and is unable to travels away from home or work and is unable to recall the past.recall the past.

Example; a women may suddenly disappear Example; a women may suddenly disappear and wake up three days later in a restaurant 200 and wake up three days later in a restaurant 200 miles from home.miles from home.

If she is not treated, she may actually establish a If she is not treated, she may actually establish a new identity – assume a new name, marry, take new identity – assume a new name, marry, take a job, and so on – in a new place.a job, and so on – in a new place.

She may repress all knowledge of a previous She may repress all knowledge of a previous life.life.

Dissociative DisordersDissociative Disorders A fugue state may last for a A fugue state may last for a

few days or even decades.few days or even decades. However long it lasts, the However long it lasts, the

individual, when she comes individual, when she comes out of it, will have no memory out of it, will have no memory of what happened during this of what happened during this period of time.period of time.

Fugue, then, is a sort of Fugue, then, is a sort of traveling amnesia, and it traveling amnesia, and it probably serves the same probably serves the same psychological function as psychological function as dissociative amnesia…The dissociative amnesia…The escape from an unbearable escape from an unbearable conflict or anxiety.conflict or anxiety.

Dissociative DisordersDissociative Disorders 3. Dissociative Identity Disorder:3. Dissociative Identity Disorder: A A

person exhibits two or more personality person exhibits two or more personality states, each with its own patterns of states, each with its own patterns of thinking and behaving.thinking and behaving.

Previously known as multiple personality Previously known as multiple personality disorder.disorder.

These different personality states may These different personality states may take control at different times.take control at different times.

Some psychologists believed that this Some psychologists believed that this division of a personality is an effort to division of a personality is an effort to escape a part of the self that he or she escape a part of the self that he or she fears.fears.

The secret self then emerges in the form The secret self then emerges in the form of a separate personality.of a separate personality.

This is the rarest of the Dissociative This is the rarest of the Dissociative Disorders.Disorders.

Schizophrenia and Mood DisordersSchizophrenia and Mood Disorders

A Story…A Story… A woman was delighted to receive a A woman was delighted to receive a

letter from her son abroad, but letter from her son abroad, but distraught when she read it;distraught when she read it;

““Dear Mother…I am writing on paper. Dear Mother…I am writing on paper. The pen I am using is from a factory The pen I am using is from a factory called Perry and Co. The factory is in called Perry and Co. The factory is in England. The city of London is in England. The city of London is in England. I know this from my school England. I know this from my school days. Then I always liked geography. days. Then I always liked geography. My last teacher in that subject was My last teacher in that subject was professor Wilikers. He was a man with professor Wilikers. He was a man with black eyes. There are also blue and black eyes. There are also blue and grey eyes and other sorts too. I have grey eyes and other sorts too. I have heard it said that snakes have green heard it said that snakes have green eyes. All people have eyes. There eyes. All people have eyes. There are some, too, who are blind.”are some, too, who are blind.”

SchizophreniaSchizophrenia The man who wrote this letter The man who wrote this letter

was later diagnosed with was later diagnosed with schizophrenia.schizophrenia.

Sufferers of schizophrenia often Sufferers of schizophrenia often have difficulty using language to have difficulty using language to communicate.communicate.

They seem to go from one phrase They seem to go from one phrase to another by random association.to another by random association.

This confused language may This confused language may result because schizophrenia result because schizophrenia affects the working memory, affects the working memory, which is used to form sentences.which is used to form sentences.

A person with schizophrenia will A person with schizophrenia will not remember the beginning of a not remember the beginning of a sentence and thus finishes it with sentence and thus finishes it with an unrelated thought.an unrelated thought.

SchizophreniaSchizophrenia While the disorders While the disorders

discussed so far are discussed so far are primarily problems of primarily problems of emotion, schizophrenia is emotion, schizophrenia is a problem of cognition, but a problem of cognition, but it also involves emotion, it also involves emotion, perception, and motor perception, and motor functions.functions.

Schizophrenia affects 1 in Schizophrenia affects 1 in 100 people worldwide, but 100 people worldwide, but the odds increase to 1 in the odds increase to 1 in 10 if someone in your 10 if someone in your family already has it.family already has it.

…Or am I?

SchizophreniaSchizophrenia Schizophrenia:Schizophrenia: A group of disorders A group of disorders

characterized by confused and disconnected characterized by confused and disconnected thoughts, emotions, and perceptions.thoughts, emotions, and perceptions.

With schizophrenia, a person’s thought With schizophrenia, a person’s thought processes are somewhat disturbed, and the processes are somewhat disturbed, and the person has lost contact with reality to a person has lost contact with reality to a considerable extent.considerable extent.

Schizophrenia is not a single problem; it has no Schizophrenia is not a single problem; it has no single cause or cure.single cause or cure.

Rather, it is a collection of symptoms that Rather, it is a collection of symptoms that indicates an individual has serious difficulties indicates an individual has serious difficulties trying to meet the demands of life.trying to meet the demands of life.

SchizophreniaSchizophrenia Many people with schizophrenia Many people with schizophrenia

experience delusions and experience delusions and hallucinations.hallucinations.

Delusions:Delusions: False beliefs that a False beliefs that a person maintains in the face of person maintains in the face of contrary evidence.contrary evidence.

Hallucinations:Hallucinations: Perceptions that Perceptions that have no direct external cause.have no direct external cause.

For example; a person with For example; a person with schizophrenia may perceive hearing schizophrenia may perceive hearing a voice, when, in fact, there is no a voice, when, in fact, there is no sound present.sound present.

Types of SchizophreniaTypes of Schizophrenia Psychologists classify schizophrenia Psychologists classify schizophrenia

into many different types:into many different types: Paranoid:Paranoid: Involves hallucinations and Involves hallucinations and

delusions or delusions or grandeurgrandeur; “I am the ; “I am the savior of my people,” or savior of my people,” or persecutionpersecution; ; “someone is always watching me…”“someone is always watching me…”

Catatonic:Catatonic: These people may remain These people may remain motionless for long periods, exhibiting motionless for long periods, exhibiting a waxy flexibility in which limbs in a waxy flexibility in which limbs in unusual positions may take a long unusual positions may take a long time to return to a resting, relaxing time to return to a resting, relaxing position. Much like the melting of a position. Much like the melting of a wax statue.wax statue.

Types of SchizophreniaTypes of Schizophrenia Disorganized:Disorganized: These people use incoherent These people use incoherent

language, inappropriate emotions, giggling for no language, inappropriate emotions, giggling for no apparent reason, generally disorganized motor apparent reason, generally disorganized motor skills, and delusions.skills, and delusions.

Remission:Remission: This label is used for anyone whose This label is used for anyone whose symptoms seem to be completely gone but still exist symptoms seem to be completely gone but still exist deep in the psyche. The expectation is that deep in the psyche. The expectation is that eventually these issues will return.eventually these issues will return.

Types of SchizophreniaTypes of Schizophrenia

Undifferentiated:Undifferentiated: Encompasses the basic Encompasses the basic symptoms of schizophrenia, such as the symptoms of schizophrenia, such as the deterioration of daily functioning, deterioration of daily functioning, hallucinations, delusions, and confusion.hallucinations, delusions, and confusion.

Causes of SchizophreniaCauses of Schizophrenia It is not fully known what exactly causes this It is not fully known what exactly causes this

disorder.disorder. It is known that schizophrenia seems to have a It is known that schizophrenia seems to have a

biological basis and can be inherited.biological basis and can be inherited. The proper workings of the brain depend on the The proper workings of the brain depend on the

correct amount of chemicals and oxygen. It is correct amount of chemicals and oxygen. It is thought that schizophrenia might be caused by a thought that schizophrenia might be caused by a lack of one or both of these items.lack of one or both of these items.

Mood DisordersMood Disorders

We all have mood swings. We all have mood swings. Sometimes we are happy or elated, while Sometimes we are happy or elated, while

other times we feel dejected, sad, or other times we feel dejected, sad, or depressed.depressed.

Yet, even when we are discouraged, most Yet, even when we are discouraged, most of us feel that we can control our emotions of us feel that we can control our emotions and that these feelings will pass.and that these feelings will pass.

But what happens if they do not?But what happens if they do not?

Mood DisordersMood Disorders

Major Depressive Disorder:Major Depressive Disorder: Severe form of Severe form of lowered mood in which a person experiences lowered mood in which a person experiences feelings of worthlessness and diminished feelings of worthlessness and diminished pleasure or interest in many activities.pleasure or interest in many activities.

This depression can range from mild sensations This depression can range from mild sensations to intensely suicidal.to intensely suicidal.

This disorder is marked by; problems eating, This disorder is marked by; problems eating, lack of physical activity, problems sleeping, lack of physical activity, problems sleeping, walking, and talking…as well as feelings of guilt, walking, and talking…as well as feelings of guilt, worthlessness, and suicide.worthlessness, and suicide.

Mood DisordersMood Disorders

Bipolar Disorder:Bipolar Disorder: Disorder in Disorder in which an individual alternates which an individual alternates between feelings of mania between feelings of mania (euphoria) and depression.(euphoria) and depression.

In the manic phase, a person In the manic phase, a person experiences elation, extreme experiences elation, extreme confusion, distractability, and confusion, distractability, and racing thoughts. Often this racing thoughts. Often this person is irresponsible, has person is irresponsible, has exaggerated self esteem, and exaggerated self esteem, and exhibits irrational behavior.exhibits irrational behavior.

ExampleExampleOn admission, she slapped the nurse, On admission, she slapped the nurse,

addressed the house physician as God, addressed the house physician as God, made the sign of the cross, and laughed made the sign of the cross, and laughed loudly when asked to put on a hospital loudly when asked to put on a hospital gown. This she promptly tore to shreds…gown. This she promptly tore to shreds…She sang at the top of her voice, She sang at the top of her voice, screamed through the window, and leered screamed through the window, and leered at the patients walking in the yard. at the patients walking in the yard. (Karnash, 1945)(Karnash, 1945)

Bipolar DisorderBipolar Disorder In the depressive phase, the individual is In the depressive phase, the individual is

overcome by feelings of failure, sinfulness, overcome by feelings of failure, sinfulness, worthlessness, and despair.worthlessness, and despair.

Example: Example: ““The patient lay in bed, immobile, with a dull, The patient lay in bed, immobile, with a dull,

depressed expression on his face. His eyes depressed expression on his face. His eyes were sunken and down. Even when spoken to, were sunken and down. Even when spoken to, he would not look at the eyes of the speaker. he would not look at the eyes of the speaker. Usually he would not respond at all to questions, Usually he would not respond at all to questions, but sometimes, after apparently great effort, he but sometimes, after apparently great effort, he would mumble something about the “scourge of would mumble something about the “scourge of God.” (Morris and Maisto, 2000)God.” (Morris and Maisto, 2000)

Bipolar DisorderBipolar Disorder In some cases, a patient will frantically In some cases, a patient will frantically

alternate between these feelings of alternate between these feelings of Euphoria and depression.Euphoria and depression.

These people rapidly make statements These people rapidly make statements that do not seem coherent or logical.that do not seem coherent or logical.