1. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Chapter 12 Psychological Disorders

2. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 12-2 MODULE 37: Normal Versus Abnormal: Making the Distinction How can we distinguish normal from abnormal behavior? What are the major perspectives on psychological disorders used by mental health professionals? What are the major categories of psychological disorders?

3. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 12-3 Defining Abnormality Behavior that causes people to experience distress and prevents them from functioning in their daily lives Deviation from the average Deviation from the ideal A sense of personal discomfort The inability to function effectively A legal concept

4. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 12-4 Figure 1 - Perspectives on Abnormality

5. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 12-5 Perspectives on Abnormality: From Superstition to Science Medical perspective Hormonal imbalance Chemical deficiency Brain injury

6. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 12-6 Perspectives on Abnormality: From Superstition to Science Psychoanalytic perspective Abnormal behavior stems from childhood conflicts over opposing wishes regarding sex and aggression Behavioral perspective The behavior itself is the problem Uses basic principles of learning

7. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 12-7 Perspectives on Abnormality: From Superstition to Science Cognitive perspective People’s thoughts and beliefs are a central component of abnormal behavior Humanistic perspective Emphasizes the responsibility people have for their own behavior, even when such behavior is abnormal Carl Rogers and Abraham Maslow

8. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 12-8 Perspectives on Abnormality: From Superstition to Science Sociocultural perspective Assumes that people’s behavior is shaped by the society and culture in which they live

9. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 12-9 DSM-IV-TR: Determining Diagnostic Distinctions DSM-IV-TR - Used to diagnose and classify abnormal behavior Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision

10. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 12-10 DSM-IV-TR: Determining Diagnostic Distinctions Axis I: Clinical Disorders Axis II: Personality Disorders and Mental Retardation Axis III: General Medical Conditions Axis IV: Psychosocial and Environmental Problems Axis V: Global Assessment of Functioning

11. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 12-11 Figure 2 - Major Diagnostic Categories

12. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 12-12 Figure 2 - Major Diagnostic Categories

13. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 12-13 DSM-IV-TR: Determining Diagnostic Distinctions Benefits Provides a descriptive system Allows communication between mental health professionals and theoretical approaches Precise classification enables researchers to explore the causes of a problem Provides a shorthand through which professionals can describe the behaviors that tend to occur together in an individual

14. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 12-14 DSM-IV-TR: Determining Diagnostic Distinctions Conning the classifiers - The shortcomings of DSM-IV-TR David Rosenhan (1970s) Sought admission to mental hospitals based on statement that he or she was hearing voices Pseudo-patients acted in a normal way after that and the hospitals still diagnosed them as severely abnormal After an initial diagnosis, mental health professionals overlook other diagnostic possibilities

15. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 12-15 MODULE 38: The Major Psychological Disorders What are the major psychological disorders?

16. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 12-16 Anxiety Disorders Occurrence of anxiety without an obvious external cause that affects daily functioning Four major types Phobic disorder Panic disorder Generalized anxiety disorder (GAD) Obsessive-compulsive disorder (OCD)

17. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 12-17 Figure 1 - Phobic Disorders

18. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 12-18 Anxiety Disorders Phobic disorder: Intense, irrational fears of specific objects or situations Social phobia Fear of strangers

19. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 12-19 Anxiety Disorders Panic disorder: Takes the form of panic attacks lasting from a few seconds to several hours Panic attacks Anxiety suddenly rises to a peak and one feels a sense of impending, unavoidable doom Can last from a few seconds to several hours Agoraphobia Fear of being in a situation in which escape is difficult and help is unavailable

20. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 12-20 Anxiety Disorders Generalized anxiety disorder: Long-term, persistent anxiety and worry Free-floating anxiety Often accompanied by physiological symptoms such as: Muscle tension Headaches Dizziness Heart palpitations Insomnia

21. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 12-21 Anxiety Disorders Obsessive-compulsive disorder: Characterized by obsessions or compulsions Obsession: Persistent unwanted thought or idea that keeps recurring Compulsion: Irresistible urge to repeatedly carry out some act that seems strange and unreasonable Posttraumatic stress disorder - Person re- experiences a stressful event in vivid flashbacks

22. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 12-22 Anxiety Disorders The causes of anxiety disorders Genetic Factors Overactive Autonomic Nervous System Biological Causes Learned response to stress Environmental Factors Inappropriate and inaccurate thoughts and beliefs about circumstances in a person’s world Cognitive Perspective

23. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 12-23 Somatoform Disorders Psychological difficulties that take on a physical (somatic) form, but for which there is no medical cause Hypochondriasis: Constant fear of illness and a preoccupation with one’s health

24. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 12-24 Somatoform Disorders Conversion disorder: Actual physical disturbance such as the inability to use a sensory organ or the complete or partial inability to move limbs Cause is purely psychological

25. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 12-25 Dissociative Disorders Characterized by the separation of different facets of a person’s personality that are normally integrated

26. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 12-26 Dissociative Disorders Dissociative identity disorder (DID): Person displays characteristics of two or more distinct personalities Formerly called multiple personality disorder Controversial diagnosis

27. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 12-27 Dissociative Disorders Dissociative amnesia: Significant, selective memory loss “Forgotten” material is still present in memory but is repressed Dissociative fugue: Individual leaves home and sometimes assumes a new identity After a period of time, they suddenly realize and forget the time spent wandering

28. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 12-28 Mood Disorders Disturbances in emotional experience that is strong enough to intrude on everyday living Major depression: Severe form of depression that interferes with concentration, decision making, and sociability Women more likely to experience major depression

29. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 12-29 Mood Disorders Mania: Extended state of intense, wild elation Bipolar disorder Formerly known as manic-depressive disorder Periods of alternating mania and depression May occur over a few days or over a period of years Periods of depression are usually longer than manic periods

30. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 12-30 Causes of Mood Disorders Genetic and biochemical roots Result of feelings of loss or of anger directed at oneself Psychological causes Stresses of life produce a reduction in positive reinforcers Behavioral theories Response to learned helplessness Faulty cognitions (Aaron Beck) Cognitive factors Evolutionary psychology

31. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 12-31 Schizophrenia Refers to a class of disorders in which severe distortion of reality occurs Characteristics Decline from previous level of functioning Disturbances of thought and speech Formal thought disorder Delusions Hallucinations and perceptual disorders Emotional disturbances Withdrawal

32. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 12-32 Figure 7 - Types of Schizophrenia

33. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 12-33 Primary Courses and Symptoms of Schizophrenia Primary Courses Symptoms Process schizophrenia Symptoms develop slowly and subtly Reactive schizophrenia Symptoms are sudden and conspicuous Type I Schizophrenia Positive symptoms are dominant Type II Schizophrenia Negative symptoms are dominant

34. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 12-34 Schizophrenia Solving the puzzle of schizophrenia: Biological causes Genetic factors Structural abnormalities Dopamine hypothesis

35. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 12-35 Figure 9 – Genetic Factors Contributing to Schizophrenia

36. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 12-36 Schizophrenia Environmental perspectives on schizophrenia Emotional and communication patterns of the families of people with schizophrenia Expressed emotion - Interaction style characterized by high levels of criticism, hostility, and emotional intrusiveness within a family Cognitive perspective Overattention or underattention to stimuli in the environment

37. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 12-37 Schizophrenia The multiple causes of schizophrenia Predisposition model of schizophrenia - Inherit a predisposition or an inborn sensitivity to schizophrenia If stressors are strong, and are coupled with a genetic predisposition, they result in the appearance of schizophrenia

38. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 12-38 Personality Disorders Characterized by a set of inflexible, maladaptive behavior patterns that keep a person from functioning appropriately in society

39. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 12-39 Personality Disorders Antisocial personality disorder Show no regard for the moral and ethical rules of society or the rights of others Lack guilt or anxiety about their wrongdoing Impulsive and lack the ability to withstand frustration Extremely manipulative May have excellent social skills “Con artists”

40. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 12-40 Personality Disorders Borderline personality disorder Difficulty developing a secure sense of who they are Tend to rely on relationships with others to define their identity Emotional volatility leads to impulsive and self- destructive behavior Feel empty and alone

41. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 12-41 Personality Disorders Narcissistic personality disorder Characterized by an exaggerated sense of self- importance Expect special treatment from others Inability to experience empathy for others

42. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 12-42 Childhood Disorders Attention-deficit hyperactivity disorder (ADHD): Marked by inattention, impulsiveness, low tolerance for frustration, and generally a great deal of inappropriate activity Produced by dysfunctions of nervous system Autism: Severe developmental disability that impairs children’s ability to communicate and relate to others

43. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 12-43 Other Disorders Psychoactive substance-use disorder Alcohol use disorders Anorexia nervosa Bulimia Binge-eating disorder Eating disorders Sexual desire disorders Sexual arousal disorders Paraphilias Sexual disorders Organic mental disorders

44. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 12-44 MODULE 48: Psychological Disorders in Perspective How prevalent are psychological disorders? What indicators signal a need for the help of a mental health practitioner?

45. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 12-45 Figure 1 - Sample of Prevalence

46. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 12-46 Figure 1 - Sample of Prevalence

47. © 2013 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 12-47 The Social and Cultural Context of Psychological Disorders Most recent version of DSM termed controversial Self-defeating personality disorder - Lacked enough research evidence Premenstrual dysphoric disorder - Classification labels normal female behavior as a disorder Other cultures might include a list of disorders that are very different from the list that appears in the current DSM