Chapter 18 Section 1 Psychological Disorders Obj: Describe the basis for classifying psychological disorders.

What are Psychological Disorders? Psychological disorders are behavior patterns or mental processes that cause serious personal suffering or interfere with a person’s ability to cope with everyday life. Many people believe that psychological disorders are uncommon, affecting relatively few individuals. It is true that the great majority of people are never admitted to mental hospitals, and most people never seek the help of psychologists or psychiatrists. And although many people have relatives they consider eccentric, few people have family members they consider to be truly abnormal.

Estimates suggest that one third of the adults in the US have experienced some type of psychological disorder. In addition to the many people with substance abuse problems, 23 percent of people in the US experience some type of psychological disorder in their lifetime. In any given month, the figure is approximately 13 percent.

Identifying Psychological Disorders Deciding whether particular behaviors, thoughts, or feelings are “normal” or “abnormal” can be difficult. What is normal is often equated with what is average for the majority of people. Using this definition of normality, deviation from the majority becomes the primary criterion for abnormality. People with psychological disorders usually do not differ much from “normal” people. In fact, the primary difference is the simple exaggeration of certain behaviors or mental processes.

Systems of Psychological Disorders Several behavior patterns and mental processes may suggest that an individual has a psychological disorder. The word suggest is important here because diagnosing an individual with a psychological disorder is often difficult, and diagnoses are not always simple or straightforward. Psychologists generally use several criteria to determine whether a person’s behavior indicates the presence of a psychological disorder. These criteria include how typical the behavior is of people in general, whether the behavior is maladaptive, whether the behavior causes the individual emotional discomfort, and whether the behavior is socially unacceptable.

Typicality – the normality of a behavior or mental process is often determined by the degree to which it is average, or typical, of the behavior or mental processes of the majority people. There are, however, problems with defining normality in terms of what is typical of most people. The fact that a behavior is not typical of most people does not mean it is abnormal. Scientific and artistic geniuses, such as Marie Curie and Pablo Picasso, certainly are not typical of people in general. That does not mean, however, that such people are abnormal.

Maladaptivity – Many psychologists believe that what makes a behavior abnormal is the fact that it is maladaptive. That is, the behavior impairs an individual’s ability to function adequately in everyday life. Behavior that causes misery and distress rather than happiness and fulfillment may be considered maladaptive. Alcohol abuse is one such behavior. Alcohol abuse often has strong negative effects on the drinker’s health, work, and family life. Abuse of alcohol may discourage the drinker from seeking healthier solutions to the problem of anxiety as well as create additional problems of its own. Behavior that is hazardous to oneself or to others may also be considered maladaptive. This type of maladaptive behavior may include threatening or attempting suicide as well as threatening or attacking other people.

It is important to note that most people who commit violent crimes do not have psychological disorders. This is because most criminals are fully aware of what they are doing. That is, they know that their behavior is illegal and that they can be held responsible for it. Equally important, the majority of people with psychological disorders, even severe psychological disorders, are not violent or dangerous.

Emotional Discomfort – Psychological disorders such as anxiety and depression cause most people great emotional discomfort. For example, people who are depressed often suffer feelings of helplessness, hopelessness, worthlessness, guilt, and extreme sadness. They may lose interest in virtually everything they once enjoyed and believe that life is not longer worth living. Such feelings are so stressful that they may lead the affected individual to consider suicide. Thus, severe emotional discomfort may be a sign of a psychological disorder.

Socially Unacceptable Behavior – Behavior that violates a society’s accepted norms may also be an indication of a psychological disorder. However whether a behavior is socially unacceptable may depend on the particular society or culture in which it occurs. What is considered normal behavior in one culture may be considered abnormal in another. Therefore, the cultural context of a behavior must be taken into account before deciding that the behavior indicates a psychological disorder.

The importance of culture is demonstrated by culture- bound syndromes, clusters of symptoms that define or describe an illness. Many behaviors associated with culture-bound syndromes would be considered abnormal by people who are unaware of the syndrome's cultural context. For example, many people in Middle Eastern cultures believe that certain inappropriate behaviors, such as banging one’s head, are due to possession of the body by a spirit. In the US, such a belief would likely be considered a sign of a serious psychological disorder. However, in the cultural context of some areas in the Middle East, spirit possession is considered to be a rational explanation of certain types of behavior, and the affected individual is not thought to have a psychological disorder.

Classifying Psychological Disorders Most psychologists believe that it is important to have a widely agreed upon classification of psychological disorders. Unless there is agreement about how to classify psychological disorders, it is difficult to know how many people have a given disorder or what other factors, such as socioeconomic status, heredity, or gender differences, may be associated with it. It is also important to classify psychological disorders so that individuals can be correctly diagnosed and treated.

The most widely used classification system for psychological disorders is the DSM, or Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association. The most recent version of the manual, the DSM-IV- TR which was published in 1994, recognizes 18 different categories of psychological disorders. Until 1980, when the third edition of the DSM was published, psychological disorders were classified on the basis of their presumed causes. For many decades, the most widely accepted causes were those suggested by Freud’s psychoanalytic theory.

Many psychologists criticized early versions of the DSM because very diverse psychological disorders were grouped together under the labels “neuroses” and “psychoses”. As a result, beginning with the DSM-III in 1980, psychological disorders have been categorized on the basis of observable signs and symptoms rather than presumed causes. The DSM is subject to ongoing revision. New categories are added and old ones deleted as knowledge of psychological disorders increases. For example, post-traumatic stress disorder was added to the DSM only after the Vietnam War, when many soldiers were found to suffer from the disorder.

The remainder of this chapter focuses on six major types of psychological disorders as classified by the DSM-IV: anxiety disorders, dissociated disorders, somatoform disorders, mood disorders, schizophrenia, and personality disorders. Many symptoms are simply exaggerations of normal thoughts, feelings, or behaviors. These symptoms do not necessarily indicate a psychological disorder. Psychological disorders can only be diagnosed by a skilled professional after careful evaluation.