Psychological Disorders Chapter 12 Psychological Disorders Copyright © Allyn & Bacon 2007

What are Psychological Disorders? The medical model takes a “disease” view, while psychology sees psychological disorders as an interaction of biological, cognitive, social, and behavioral factors. Copyright © Allyn & Bacon 2007

What are Psychological Disorders? Psychopathology – Any pattern of emotions, behaviors, or thoughts inappropriate to the situation and leading to personal distress or the inability to achieve important goals. Also referred to as: Mental illness Mental disorder Psychological disorder Copyright © Allyn & Bacon 2007

What are Psychological Disorders? Three classic signs suggest severe psychopathology: 1. Hallucinations -false sensory experiences that may suggest mental disorder. 2. Delusions -persistent false beliefs. 3. Severe affective disturbances -emotion or mood. Copyright © Allyn & Bacon 2007

Copyright © Allyn & Bacon 2007 The Medical Model The view that mental disorders are diseases that, like ordinary physical diseases, have objective physical causes and require specific treatments. Mental disorders are best treated with drug therapy. Copyright © Allyn & Bacon 2007

The Cognitive-Behavioral Approach Behavioral perspective – Abnormal behaviors can be acquired through behavioral learning – operant and classical conditioning. Cognitive perspective – Abnormal behaviors are influenced by mental processes – how people perceive themselves and their relations with others. Copyright © Allyn & Bacon 2007

The Social-Cognitive-Behavioral Approach A psychological alternative to the medical model that views psychological disorder through a combination of the social, cognitive, and behavioral perspectives. Cognition Environment Behavior Copyright © Allyn & Bacon 2007

Indicators of Abnormality Other signs of a disorder are more subtle, and a diagnosis depends heavily on clinical judgment. Distress Maladaptiveness Irrationality Unpredictability Unconventionality and undesirable behavior Copyright © Allyn & Bacon 2007

How are Psychological Disorders Classified? The most widely used system, found in the DSM-IV, classifies disorders by their mental and behavioral symptoms. Copyright © Allyn & Bacon 2007

Copyright © Allyn & Bacon 2007 Overview of DSM-IV DSM-IV – Fourth edition of the Diagnostic and Statistical Manual of Mental Disorders; the most widely accepted classification system in the United States. In multiaxial diagnosis, professionals look at the entire person, not just their “abnormal” behavior. Copyright © Allyn & Bacon 2007

Copyright © Allyn & Bacon 2007 DSM - IV Axis I Clinical disorders Axis II Personality disorders and Mental retardation Axis III General medical conditions Axis IV Psychosocial and environmental factors Axis V Global assessment of functioning Copyright © Allyn & Bacon 2007

Axis I – Clinical Disorders Anxiety Disorders Eating Disorders Bipolar Disorder Depression Schizophrenia Phobias ADHD Substance abuse Copyright © Allyn & Bacon 2007

Axis II – Personality Disorders & Mental Retardation Paranoid Antisocial Avoidant Borderline Narcissistic MR (mild, moderate, severe, profound) Copyright © Allyn & Bacon 2007

Axis III – General Medical Conditions Infectious diseases Complications of pregnancy Diabetes Brain injury Poisoning Alcohol cirrhosis Copyright © Allyn & Bacon 2007

Axis IV – Psychosocial & Environmental Factors Legal difficulties Occupational problems Educational problems Economic problems Divorce Unemployment Crime Copyright © Allyn & Bacon 2007

Axis V – Global Assessment of Functioning (GAF) Measures patients overall levels of functioning. 100 point scale GAF scale: - Plan treatment - Measure its impact - Predict outcomes Copyright © Allyn & Bacon 2007

Copyright © Allyn & Bacon 2007 Example: Axis I: Major Depressive Disorder, Alcohol Abuse Axis II: Dependent Personality Disorder, Frequent use of denial Axis III: None Axis IV: Threat of job loss Axis V: GAF = 35 (current) Copyright © Allyn & Bacon 2007

Copyright © Allyn & Bacon 2007 Mood Disorders Major Depression A condition lasting most of the day, day after day, with a loss of interest and pleasure and a lack of productive activity. Symptoms: -Trouble concentrating -Lack of appetite -Sleep abnormalities -Feelings of worthlessness Copyright © Allyn & Bacon 2007

Copyright © Allyn & Bacon 2007 Causes: Genetic predisposition Biological basis Environment Low self-esteem Gender differences Cognitive aspects Copyright © Allyn & Bacon 2007

Copyright © Allyn & Bacon 2007 Mood Disorders Seasonal Affective Disorder (SAD) A condition in which people become seriously depressed in one season of the year; usually winter. Causes: Deprivation of sunlight Copyright © Allyn & Bacon 2007

Copyright © Allyn & Bacon 2007 Mood Disorders Bipolar Disorder A condition in which a person alternates between periods of depression and periods of mania (excessive elation or manic excitement). Causes: Genetic component Copyright © Allyn & Bacon 2007

Copyright © Allyn & Bacon 2007 Anxiety Disorders Mental problems characterized mainly by anxiety. Anxiety Disorders Copyright © Allyn & Bacon 2007

Copyright © Allyn & Bacon 2007 Anxiety Disorders Generalized anxiety disorder – Characterized by persistent and pervasive feelings of anxiety, without any external cause. Panic disorder – Marked by panic attacks that have no connection to events in a person’s present experience. Agoraphobia – Fear of public places/open spaces. Copyright © Allyn & Bacon 2007

Copyright © Allyn & Bacon 2007 Anxiety Disorders Phobias– A group of anxiety disorders involving a pathological fear of a specific object or situation. Preparedness hypothesis – Notion that we have an innate tendency, acquired through natural selection, to respond quickly and automatically to stimuli that posed a survival threat to our ancestors. Copyright © Allyn & Bacon 2007

Copyright © Allyn & Bacon 2007 Obsessive-compulsive disorder – Condition characterized by patterns of persistent, unwanted thoughts and behaviors. Anxiety Disorders The 3 C’s Copyright © Allyn & Bacon 2007

Copyright © Allyn & Bacon 2007 Somatoform Disorders Somatoform disorders – Psychological problems appearing in the form of bodily symptoms or physical complaints. Conversion disorder – Somatoform disorder marked by paralysis, weakness, or loss of sensation, but with no discernable physical cause. Copyright © Allyn & Bacon 2007

Copyright © Allyn & Bacon 2007 Somatoform Disorders Hypochondriasis – Somatoform disorder involving excessive concern about health and disease. Copyright © Allyn & Bacon 2007

Dissociative Disorders Dissociative disorders – Group of pathologies involving “fragmentation” of the personality. Dissociative amnesia Dissociative fugue Depersonalization disorder Dissociative identity disorder Copyright © Allyn & Bacon 2007

Dissociative Disorders Dissociative amnesia A psychologically induced loss of memory for personal information. Dissociative fugue Depersonalization disorder Dissociative identity disorder Copyright © Allyn & Bacon 2007

Dissociative Disorders Dissociative amnesia Dissociative fugue Dissociative amnesia with the addition of “flight” from one’s home, family, and job. Depersonalization disorder Dissociative identity disorder Copyright © Allyn & Bacon 2007

Dissociative Disorders Dissociative amnesia Dissociative Fugue Abnormality involving the sensation of mind and body having separated. Depersonalization disorder Dissociative identity disorder Copyright © Allyn & Bacon 2007

Dissociative Disorders Dissociative amnesia Dissociative Fugue Depersonalization disorder Condition in which the individual displays multiple identities. Dissociative identity disorder Copyright © Allyn & Bacon 2007

Copyright © Allyn & Bacon 2007 Eating Disorders Anorexia nervosa – Eating disorder involving persistent loss of appetite that endangers an individual’s health – stemming from psychological reasons rather than organic causes. Bulimia – Eating disorder characterized be eating binges followed by “purges,” induced by vomiting or laxatives; typical initiated as a weight-control measure. Copyright © Allyn & Bacon 2007

Schizophrenic Disorders Schizophrenia – Psychotic disorder involving distortions in thoughts, perceptions, and/or emotions. Copyright © Allyn & Bacon 2007

Major Types of Schizophrenia Disorganized Catatonic Paranoid Undifferentiated Residual Positive Negative Copyright © Allyn & Bacon 2007

Major Types of Schizophrenia Features incoherent speech, hallucinations, delusions, and bizarre behavior. Disorganized Catatonic Paranoid Undifferentiated Residual Type Copyright © Allyn & Bacon 2007

Major Types of Schizophrenia Disorganized Catatonic Involves a spectrum of motor dysfunctions: catatonic stupor and catatonic excitement. Paranoid Undifferentiated Residual Type Copyright © Allyn & Bacon 2007

Major Types of Schizophrenia Disorganized Catatonic Paranoid Prominent feature: delusions of persecution and grandiosity. Undifferentiated Residual Type Copyright © Allyn & Bacon 2007

Major Types of Schizophrenia Disorganized Catatonic Paranoid Undifferentiated Persons displaying a combination of symptoms that do not clearly fit in one of the other categories. Residual Type Copyright © Allyn & Bacon 2007

Major Types of Schizophrenia Disorganized Catatonic Paranoid Undifferentiated Residual Type Individuals who have had a past episode of schizophrenia but are free of symptoms. Copyright © Allyn & Bacon 2007

Major Types of Schizophrenia Positive Schizophrenia Any form in which the person displays active symptoms. (e.g. delusions, hallucinations) Negative Schizophrenia Copyright © Allyn & Bacon 2007

Major Types of Schizophrenia Positive Schizophrenia Negative Schizophrenia Any form distinguished by deficits, such as withdrawal and poverty of thought processes. Copyright © Allyn & Bacon 2007

Possible Causes of Schizophrenia Evidence for the causes of schizophrenia has been found in a variety of factors including genetics, abnormal brain structure, and biochemistry. Diathesis-stress hypothesis – Genetic factors place the individual at risk, but environmental stress factors transform this potential into an actual schizophrenic disorder. Copyright © Allyn & Bacon 2007

Personality Disorders Personality disorders – Conditions involving a chronic, pervasive, inflexible, and maladaptive pattern of thinking, emotion, social relationships, or impulse control. Copyright © Allyn & Bacon 2007

Personality Disorders Narcissistic personality disorder Characterized by a grandiose sense of self-importance, a preoccupation with fantasies of success and power, and a need for constant attention. Copyright © Allyn & Bacon 2007

Personality Disorders Antisocial personality disorder – Characterized by a long-standing pattern of irresponsible behavior indicating a lack of conscience and a diminished sense of responsibility to others. Copyright © Allyn & Bacon 2007

Personality Disorders Borderline personality disorder – An unstable personality given to impulsive behavior. Copyright © Allyn & Bacon 2007

Developmental Disorders Autism – A developmental disorder marked by disabilities in language, social interaction, and the ability to understand another person’s state of mind. Dyslexia – A reading disability, thought by some experts to involve a brain disorder. Copyright © Allyn & Bacon 2007

Developmental Disorders Attention-deficit hyperactivity disorder – A developmental disability involving short attention span, distractibility, and extreme difficulty in remaining inactive for any period.                           Copyright © Allyn & Bacon 2007

Parent-child problems Adjustment Disorders and Other Conditions That May Be a Focus of Clinical Attention Mild depression Marital problems Physical complaints Academic problems Parent-child problems Job problems Bereavement Malingering Copyright © Allyn & Bacon 2007

What are the Consequences of Labeling People? Ideally, accurate diagnoses lead to proper treatments, but diagnoses may also become labels that depersonalize individuals and ignore the social and cultural contexts in which their problems arise. Copyright © Allyn & Bacon 2007

Copyright © Allyn & Bacon 2007 A defendant is not criminally responsible if, at the time of committing an unlawful act, the person was laboring under such a defect of reason, from disease of the mind, as not to know the nature and quality of the act he was doing; or if he did know it, that he did not know he was doing wrong. Daniel M‘Naghten Prime Minister Sir Robert Peel Edward Drummond M’Naghten Rule Copyright © Allyn & Bacon 2007

Copyright © Allyn & Bacon 2007 The Plea of Insanity “Not guilty by reason of insanity” Insanity – A legal term, not a psychological one, referring to a person who is unable, because of a mental disorder or defect, to confirm his or her behavior to the law. Copyright © Allyn & Bacon 2007

Copyright © Allyn & Bacon 2007 End of Chapter 12 Copyright © Allyn & Bacon 2007