1. 6 th Edition Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-1 Psychology Stephen F. Davis Morningside College Joseph J. Palladino University of Southern Indiana PowerPoint Presentation by Fred W. Whitford Montana State University This multimedia product and its contents are protected under copyright law. The following are prohibited by law: any public performance or display, including transmission of any image over a network; preparation of any derivative work, including the extraction, in whole or in part, of any images; any rental, lease, or lending of the program.

2. 6 th Edition Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-2 Psychological Disorders Chapter 12

3. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-3 Abnormal Behavior The most commonly used criteria for distinguishing between normal and abnormal behaviors are statistical rarity, interference with normal functioning, personal distress, and deviance from social norms. By the standard of statistical rarity, behavior is abnormal when it does not occur very often. By itself, statistical rarity is clearly not a consistently useful indicator of what we should label abnormal.

4. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-4 Abnormal Behavior Dysfunctional behavior interferes with a person’s ability to function in day-to-day life. People may be diagnosed as suffering from a psychological disorder if their behavior is upsetting, distracting, or confusing to themselves. The distress criterion is useful in cases in which the psychological disorder is accompanied by discomfort.

5. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-5 Abnormal Behavior Departures from social norms are used to define deviant, and therefore abnormal behaviors; social norms, however, can change over time and vary across groups. We can define behaviors as abnormal when they are statistically unusual, are not socially approved, and cause distress to the person or interfere with his or her ability to function. Because different cultural groups have different social norms, definitions of abnormality using this criterion are culturally variable.

6. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-6 Abnormal Behavior Insanity is a legal ruling that an accused individual is not responsible for a crime. Insanity is defined in most states as the inability to tell the difference between right and wrong at the time the crime is committed. Contrary to the public’s understanding of the insanity plea, such pleas are infrequently used and rarely successful.

7. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-7 Abnormal Behavior The medical model views abnormal behaviors as no different from illnesses and seeks to identify symptoms and prescribe medical treatments. The psychodynamic model views psychological disorders as resulting from unconscious conflicts related to sex and aggression.

8. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-8 Abnormal Behavior The behavioral model views abnormal behaviors as learned through classical conditioning, operant conditioning, and modeling. The cognitive model suggests that our interpretation of events and our beliefs influence our behavior.

9. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-9 Abnormal Behavior The sociocultural model emphasizes the importance of social and cultural influences on the frequency, diagnosis, and conception of psychological disorders. There is a growing recognition that many disorders have multiple causes; thus the simultaneous use of several models is likely to advance our understanding. This emphasis on multiple causation is evident in the biopsychosocial model, which incorporates biological (medical-model) factors along with psychological and sociocultural (social) factors.

10. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-10 Classifying and Counting Psychological Disorders Diagnosis is the process of deciding whether a person has symptoms that meet established criteria of an existing classification system. A major purpose of diagnosis is to make predictions regarding the course of the disorder, whether it will respond to treatment, and which treatment is best.

11. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-11 Classifying and Counting Psychological Disorders The most frequently used system for classifying psychological disorders is the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR).

12. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-12 Classifying and Counting Psychological Disorders Rosenhan’s pseudopatient study raises questions about our ability to distinguish normal and abnormal behaviors and shows how labels affect the perception of behavior.

13. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-13 Classifying and Counting Psychological Disorders Epidemiologists study the distribution and factors associated with accidents, diseases, and psychological disorders. Epidemiologists are interested in the prevalence of disorders—the percentage of a population or the number of persons experiencing a given disorder during some specified period. The incidence of a disorder is the rate (or number) of new cases reported during a given period.

14. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-14 Classifying and Counting Psychological Disorders One-year prevalence estimates for selected psychological disorders based on combined data from the Epidemiologic Catchment Area Study and the National Comorbidity Survey.

15. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-15 Classifying and Counting Psychological Disorders Phobias, alcohol and drug abuse or dependence, and major depressive disorder are among the most common psychological disorders. These and other psychological disorders are often comorbid, meaning they occur with other disorders.

16. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-16 Classifying and Counting Psychological Disorders The simultaneous occurrence of disorders, or comorbidity, makes it more difficult to make appropriate diagnoses and to develop effective treatment plans.

17. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-17 Anxiety, Somatoform, and Dissociative Disorders Anxiety is a general feeling of apprehension characterized by behavioral, cognitive, or physiological symptoms. Phobias are excessive, irrational fears of activities, objects, or situations. Agoraphobia is the most common phobia treated in mental health clinics.

18. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-18 Anxiety, Somatoform, and Dissociative Disorders Agoraphobia is the avoidance of public places or situations in which escape may be difficult should the individual develop incapacitating or embarrassing symptoms of panic. Social phobia refers to a fear related to being seen or observed by others.

19. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-19 Anxiety, Somatoform, and Dissociative Disorders A specific phobia is any phobia other than agoraphobia or the social phobias, including the fear of specific animals, of elements of the natural environment, and of such things as blood, injections, or injury.

20. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-20 Anxiety, Somatoform, and Dissociative Disorders Specific phobias are not uncommon.

21. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-21 Anxiety, Somatoform, and Dissociative Disorders Classical conditioning and modeling (vicarious conditioning) have been offered as explanations for the development of phobias. Panic disorder is the most severe anxiety disorder, characterized by intense physiological arousal not related to a specific stimulus. About 50% of the people who suffer from panic attacks also experience agoraphobia.

22. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-22 Anxiety, Somatoform, and Dissociative Disorders Rapid increase in heart rate during a panic attack.

23. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-23 Anxiety, Somatoform, and Dissociative Disorders A number of tests called biological challenges have revealed that certain biologically related phenomena can bring on panic attacks. According to cognitive psychologists, panic attacks occur when the bodily sensations of anxiety are misinterpreted as signs of impending disaster.

24. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-24 Anxiety, Somatoform, and Dissociative Disorders Generalized anxiety disorder (GAD) involves a chronically high level of anxiety that is not attached to a specific stimulus (it is free-floating). GAD, along with some other anxiety disorders, may result from low levels of the inhibitory neurotransmitter gamma- aminobutyric acid (GABA).

25. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-25 Anxiety, Somatoform, and Dissociative Disorders Obsessive–compulsive disorder (OCD) is an anxiety disorder characterized by repetitive, irrational, intrusive thoughts, impulses, or images (obsessions) and irresistible, repetitive acts (compulsions) such as checking that doors are locked or washing hands.

26. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-26 Anxiety, Somatoform, and Dissociative Disorders Behavioral psychologists view compulsions as learned habits that reduce anxiety. That is, the compulsive behavior has been associated with anxiety reduction through operant conditioning. OCD runs in families; identical twins are more likely than fraternal twins to share the disorder.

27. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-27 Anxiety, Somatoform, and Dissociative Disorders Posttraumatic stress disorder (PTSD) is a reaction to a traumatic or life-threatening situation; this is characterized by repeated reexperiencing of the traumatic event, avoidance of reminders of the situation, emotional numbness, and increase arousal.

28. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-28 Anxiety, Somatoform, and Dissociative Disorders Somatoform disorders involve complaints of bodily symptoms that do not have a known medical cause; instead psychological factors are involved. Among these disorders are hypochondriasis, somatization disorder and conversion disorder.

29. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-29 Anxiety, Somatoform, and Dissociative Disorders Hypochondriasis is a somatoform disorder in which a person believes that he or she has a serious disease despite repeated medical findings to the contrary. People with somatization disorder present vague but complicated and dramatic medical histories. In contrast to hypochondriasis, which centers on some specific disease, somatization disorder involves a large number of symptoms.

30. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-30 Anxiety, Somatoform, and Dissociative Disorders Conversion disorder involves mainly sensory and motor functions that are normally under voluntary control. Consequently, symptoms can be dramatic and include apparent blindness, deafness, paralysis, and seizures.

31. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-31 Anxiety, Somatoform, and Dissociative Disorders Dissociative disorders involve disruptions in a particular function of the mind, such as memory of events, knowledge of one’s identity, or consciousness. Dissociative amnesia is a dissociative disorder that involves a sudden inability to recall important personal information; it often occurs in response to trauma or extreme stress.

32. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-32 Anxiety, Somatoform, and Dissociative Disorders Dissociative fugue is a dissociative disorder involving amnesia and flight from the workplace or home; it may involve establishing a new identity in a new location. Dissociative identity disorder (multiple personality) is a dissociative disorder in which a person has two or more separate personalities, which usually alternate.

33. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-33 Anxiety, Somatoform, and Dissociative Disorders There are usually three or four personalities or alters (short for alternate identities), although more than 100 have been reported in a single individual. The alters in dissociative identity disorder often contrast sharply with one another and have very different personal histories, behavior patterns, friends, beliefs, habits, values, and even voices and facial expressions.

34. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-34 Anxiety, Somatoform, and Dissociative Disorders Depersonalization disorder is a disorder in which the person has a persistent or recurring depersonalization episode that interferes with normal functioning.

35. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-35 Mood Disorders Mood disorders occur at both ends of a continuum ranging from severe depression to excessive euphoria. The symptoms of depression fall into four broad categories: emotional, cognitive, motivational, and somatic/behavioral. The most obvious symptoms of depression are sadness (dysphoria), lack of interest in previously pleasurable activities, and reduced energy.

36. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-36 Mood Disorders Depressed people often describe themselves in unflattering terms such as inferior and unattractive. They do not see themselves as capable of completing intellectually demanding tasks. Two forms of insomnia are frequently associated with depression: difficulty falling asleep (sleep- onset insomnia) and awakening early in the morning with an inability to return to sleep.

37. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-37 Mood Disorders Major depression is the fourth leading cause of worldwide disease and is responsible for more disability than heart disease. Major depression is one of the most commonly identified psychological disorders in the United States. Depression strikes children as well as adults. In many cultures, the rate of depression is twice as high among women as among men.

38. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-38 Mood Disorders Poverty is a path to depression, and the rate of poverty is especially high among women and children. The rate of depression has risen dramatically over the past century. Although depression usually diminishes with time (typically within 6 months), episodes tend to recur.

39. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-39 Mood Disorders Suicide, which is often associated with depression, is one of the leading causes of death in the United States. The risk factors for suicide include being male, unmarried, and depressed. If you suspect that someone you know might attempt suicide, you should not be afraid to ask, “Are you thinking about suicide?”

40. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-40 Mood Disorders People who talk about or attempt suicide need immediate medical and psychological help. Most suicidal people are ambivalent about committing suicide; they are experiencing pain, helplessness, and hopelessness. Time is an important ally in the effort to prevent a suicide because people do not usually remain seriously suicidal for long.

41. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-41 Mood Disorders Mania refers to excessive activity, accelerated speech, poor judgment, elevated self-esteem, and euphoria that occur in bipolar disorder. Bipolar disorder is a mood disorder in which a person experiences episodes of mania and depression, which usually alternate.

42. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-42 Mood Disorders Experts believe that biological factors play a role in the development of mood disorders. The symptoms of depression tend to be similar across cultures, suggesting a common underlying biological cause. Drugs such as Elavil and Prozac reduce depression; mania responds to lithium treatment.

43. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-43 Mood Disorders Mood disorders tend to run in families, which suggests genetic transmission.

44. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-44 Mood Disorders A twin pair is said to be concordant when both twins have mood disorders. The concordance rate is the percentage of twin pairs in which both twins have the disorder. The concordance rate for mood disorders among identical twins is approximately 65%; the rate among fraternal twins is about 14%.

45. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-45 Mood Disorders Depression may involve low levels of norepinephrine or serotonin. According to the learned helplessness model, depression can also be brought on when people believe that they cannot control outcomes.

46. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-46 Mood Disorders The psychodynamic model emphasizes early childhood experiences as the foundation of adult behavior and emotional reactions.

47. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-47 Mood Disorders Learned helplessness occurs when you believe you have no control over the reinforcements in your life. This model of depression explains the lethargy and lack of motivation seen in depressed individuals.

48. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-48 Mood Disorders A reformulation of the learned helplessness model, called the hopelessness model, focuses on people’s beliefs about the situations in which they find themselves. Some people become depressed not because they lack control over a situation but because of the way they explain the situation.

49. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-49 Mood Disorders The hopelessness model has much in common with the cognitively oriented theories of researchers who view depression as stemming from problems in the way people think. Depressed people may draw arbitrary inferences, conclusions drawn in the absence of supporting information.

50. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-50 Schizophrenia Schizophrenia is a psychotic disorder that is characterized by positive symptoms (excesses) or negative symptoms (deficits). Psychosis is a general term for disorders in which severely disturbed people lose contact with reality and may require hospitalization.

51. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-51 Schizophrenia Schizophrenia is often confused with dissociative identity disorder. The “split” in schizophrenia, however, is not among different personalities; it is a split from reality as well as a split between thoughts and emotions.

52. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-52 Schizophrenia The positive symptoms of schizophrenia are distortions or excesses of normal functions, such as fluent but disorganized speech, delusions, and hallucinations. While listening to the speech of a patient with schizophrenia, you may struggle to follow his or her pattern of thought; the disorganized speech is thought to reflect disturbances in the underlying thought processes.

53. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-53 Schizophrenia The ideas expressed by a person with schizophrenia can be like a train that has slipped off its track onto another track; this pattern of speech is called loose associations. Among the most frequently observed positive symptoms are delusions, or false beliefs that cannot be corrected despite strong evidence to the contrary.

54. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-54 Schizophrenia Hallucinations are perceptions that are not caused by stimulation of the relevant sensory receptors. They can occur in any of the senses, although auditory hallucinations are the most common.

55. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-55 Schizophrenia Negative symptoms are reductions or losses of function. These behavior deficits or defects include poverty of speech as well as disturbances in affect and volition (will). These symptoms are associated with more cognitive impairment and poorer prognoses than positive symptoms.

56. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-56 Schizophrenia The speech of people with schizophrenia may be adequate in amount yet convey little information: Language that is vague, too abstract, too concrete, or repetitive is termed poverty of content. A restriction in the amount of spontaneous speech that is evident in brief and unelaborated replies to questions is called poverty of speech.

57. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-57 Schizophrenia Failure to experience any emotion is called flat affect; an inability to experience the typical range of emotions is called blunted affect. Avolition (difficulty making decisions) and apathy are characterized by a lack of energy and drive such that a person is unable to initiate or persist in tasks. A number of disturbances in motor movements and a lack of self-care also characterize some forms of schizophrenia.

58. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-58 Schizophrenia The DSM-IV lists five subtypes of schizophrenia: catatonic, disorganized, paranoid, residual, and undifferentiated. Each subtype of schizophrenia is characterized by a different set of symptoms, although distinctions among the types are not always clear-cut and there is significant overlap in symptoms. Indeed, the undifferentiated subtype is a category for cases that do not fit into other subtypes.

59. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-59 Schizophrenia Schizophrenia tends to run in families. The risk of developing the disorder increases with the degree of genetic relatedness between an individual and a family member who has schizophrenia.

60. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-60 Schizophrenia Prevalence estimates range from.5% to 1.5%. Onset for men is mid-teens to early 20s and mid-to-late 20s for women. Prognosis is relatively positive with 30% eventually able to return to work.

61. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-61 Schizophrenia Evidence of various brain abnormalities, including larger ventricles, in people with schizophrenia suggests a possible biological cause. The neurotransmitter dopamine seems to be involved in the development of schizophrenia.

62. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-62 Schizophrenia Environmental influences on schizophrenia include stress and hostile family communication. Researchers are beginning to converge on what they have called a neurodevelopmental model, which suggests that schizophrenia results from a combination of a genetic predisposition along with other factors.

63. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-63 Personality and Sexual Disorders and Substance Use Disorders Personality disorders are long-standing patterns of maladaptive behavior that are usually evident during the adolescent years and are resistant to treatment.

64. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-64 Personality and Sexual Disorders and Substance Use Disorders The DSM-IV-TR describes 10 personality disorders divided into three clusters: –odd or eccentric behavior; paranoid, schizoid and schizotypal –dramatic, emotional, or erratic behavior; antisocial, borderline, histrionic and narcissistic –anxious or fearful behavior; avoidant dependent and obsessive-compulsive

65. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-65 Personality and Sexual Disorders and Substance Use Disorders Antisocial personality disorder is a personality disorder characterized by deceitful, impulsive, reckless actions that violate social norms for which the individual feels no remorse. In the past, the terms psychopath and sociopath have been used to describe this behavior pattern.

66. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-66 Personality and Sexual Disorders and Substance Use Disorders The signs of disturbance seen in other disorders—anxiety, depression, delusions, or hallucinations—are absent in antisocial personality disorder. Individuals with this disorder rarely seek professional help unless their goal is to obtain an excuse to be absent from work, to acquire drugs, or to avoid prison by submitting to court-ordered treatment.

67. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-67 Personality and Sexual Disorders and Substance Use Disorders Because antisocial individuals do not experience the warning signals of anxiety, they are prone to act impulsively, without regard for the feelings or well-being of others. They want immediate gratification, fail to develop emotional attachments, and have no remorse for their actions. Antisocial persons do not develop conditioned fear responses readily.

68. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-68 Personality and Sexual Disorders and Substance Use Disorders The DSM-IV-TR divides sexual disorders into several categories: gender identity disorder (transsexualism), the paraphilias, and sexual dysfunctions. Gender identity disorder (transsexualism) is a sexual disorder in which a person believes that he or she was born with the wrong biological sex organs.

69. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-69 Personality and Sexual Disorders and Substance Use Disorders Paraphilia refers to sexual arousal by objects or situations not considered sexual by most people. Fetishism is a paraphilia in which a person is sexually aroused by unusual objects or body parts.

70. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-70 Personality and Sexual Disorders and Substance Use Disorders Psychodynamic theorists see paraphilias as associated with early childhood experiences or, in some cases, as alternatives that arouse less anxiety than sexual encounters with adult partners. Behavioral psychologists, in contrast, believe that most fetishes, and probably many of the paraphilias, develop through classical conditioning.

71. Copyright © 2010 Pearson Education, Inc., Upper Saddle River, NJ 07458. All rights reserved. 12-71 Personality and Sexual Disorders and Substance Use Disorders “Substance” has eleven separate categories, with alcohol being the most widely used.