1. 15
Psychological Disorders

2. Diagnosing Mental Disorders LO15
Diagnosing Mental Disorders LO15.1 Consider why it is difficult to obtain a universally agreed upon definition of “mental disorder.”
Diagnosing mental disorders
Any behavior or emotional state that causes a person to suffer, is self-destructive; seriously impairs the person’s ability to work or get along with others; or endangers others or the community.

3. Diagnosing Mental Disorders, cont’ LO15
Diagnosing Mental Disorders, cont’ LO15.2 Describe four dangers associated with using the DSM for diagnosis of mental disorders, and give an example of each.
Explosion of mental disorders
Supporters of new categories answer that it is important to distinguish disorders precisely.
Critics point to economics: diagnoses are needed for insurance reasons for therapists to be compensated.

4. Diagnosing Mental Disorders, cont’ LO15
Diagnosing Mental Disorders, cont’ LO15.2 Describe four dangers associated with using the DSM for diagnosis of mental disorders, and give an example of each.
Concerns about the DSM
The danger of over-diagnosis
The power of diagnostic labels
Confusion of serious mental disorders with normal problems
The illusion of objectivity

5. Diagnosing Mental Disorders, cont’ LO15
Diagnosing Mental Disorders, cont’ LO15.2 Describe four dangers associated with using the DSM for diagnosis of mental disorders, and give an example of each.
Advantages of the DSM
When the manual is used correctly and diagnoses are made with valid objective tests, the DSM improves the reliability of and agreement between clinicians.

6. Diagnosing Mental Disorders, cont’ LO15
Diagnosing Mental Disorders, cont’ LO15.2 Describe four dangers associated with using the DSM for diagnosis of mental disorders, and give an example of each.
Culture and DSM
Culture-bound syndromes
Symptoms or mental disorders that are specific to particular cultural contexts and practices.
Example
Native American tribes
Ghost sickness: Preoccupation with death and the dead, with bad dreams, fainting, appetite loss, fear, hallucinations, etc.

7. Diagnosing Mental Disorders, cont’ LO15
Diagnosing Mental Disorders, cont’ LO15.3 Explain the theoretical basis of projective tests, and identify the problems associated with these techniques.
Dilemmas of Measurement
Projective tests
Psychological tests used to infer a person’s motives and conflicts, and unconscious dynamics on the basis of the person’s interpretation of ambiguous stimuli.
Rorschach inkblot test: A projective personality test that asks respondents to interpret abstract, symmetrical inkblots.

8. Diagnosing Mental Disorders, cont’ LO15
Diagnosing Mental Disorders, cont’ LO15.3 Explain the theoretical basis of projective tests, and identify the problems associated with these techniques.
Objective tests
Inventories
Standardized objective questionnaires requiring written responses
Typically include scales on which people are asked to rate themselves
Inventories are generally more reliable and valid than either projective methods or subjective clinical judgments.

9. Diagnosing Mental Disorders, cont’ LO15
Diagnosing Mental Disorders, cont’ LO15.3 Explain the theoretical basis of projective tests, and identify the problems associated with these techniques.
Minnesota Multiphasic
Personality Inventory
A widely used personality instrument
Mostly used in clinical settings
Measures aspects of personality that, if extreme, suggest a problem
For example, extreme suspiciousness

10. Diagnosing Mental Disorders, cont’ LO15
Diagnosing Mental Disorders, cont’ LO15.3 Explain the theoretical basis of projective tests, and identify the problems associated with these techniques.
Characteristics of MMPI
Has several different scales
Scales thought to measure different kinds of psychological disorders
Scale scores indicate how you compare with others
Overall assessment is interpretive
Inspect profile of different scales.

11. Diagnosing Mental Disorders, cont’ LO15
Diagnosing Mental Disorders, cont’ LO15.3 Explain the theoretical basis of projective tests, and identify the problems associated with these techniques.
MMPI validity scales
Four validity scales designed to determine whether respondent is presenting self accurately
Fail to consider differences among cultural, regional, and socioeconomic groups.

12. Anxiety Disorders LO15.4 Differentiate the major symptoms of generalized anxiety disorder, post-traumatic stress disorder, and panic disorder.
Generalized anxiety disorder
Continuous state of anxiety marked by feelings of worry and dread, apprehension, difficulties in concentration, and signs of motor tension.
Genes may be involved in causing abnormalities in the amygdala and the prefrontal cortex.
Some chronically anxious people have a history, starting in childhood, of being unable to control or predict their environments.

13. Anxiety Disorders LO15.4 Differentiate the major symptoms of generalized anxiety disorder, post-traumatic stress disorder, and panic disorder.
Posttraumatic stress disorder
An anxiety disorder in which a person who has experienced a traumatic or life-threatening event has symptoms such as psychic numbing, reliving of the trauma, and increased physiological arousal.
Diagnosed only if symptoms persist for one month or longer
May immediately follow event or occur later

14. Anxiety Disorders LO15.4 Differentiate the major symptoms of generalized anxiety disorder, post-traumatic stress disorder, and panic disorder.
Panic disorder
An anxiety disorder in which a person experiences recurring panic attacks
Panic attack: a feeling of impending doom or death, accompanied by physiological symptoms such as rapid breathing and dizziness
Panic attack
interpretation
“It’s just stress”
“OMG, I’m dying!!”
No disorder
Panic disorder

15. Anxiety Disorders, cont’ LO15
Anxiety Disorders, cont’ LO15.5 Describe the characteristics of a phobia, and explain why agoraphobia can be so disabling.
Phobias
Phobia: An exaggerated, unrealistic fear of a specific situation, activity, or object.
Social phobia: Individuals become extremely anxious in situations in which they will be observed by others—eating in a restaurant, speaking in public, having to perform for an audience
Agoraphobia: A set of phobias, often set off by a panic attack, involving the basic fear of being away from a safe place or person.

16. Anxiety Disorders, cont’ LO15
Anxiety Disorders, cont’ LO15.6 Distinguish between obsessions and compulsions, and discuss the defining elements of obsessive-compulsive disorder.
Obsessive-compulsive disorder (OCD)
An anxiety disorder in which a person feels trapped in repetitive, persistent thoughts (obsessions) and repetitive, ritualized behaviors (compulsions) designed to reduce anxiety.
Person understands that the ritual behavior is senseless but guilt mounts if the behavior is not performed.

17. Mood Disorders LO15.7 Describe how major depression differs from normal feelings of sadness or loneliness.
Depression
Major depression
A mood disorder involving disturbances in emotion (excessive sadness), behavior (loss of interest in one’s usual activities), cognition (thoughts of hopelessness), and body function (fatigue and loss of appetite).

18. DSM IV requires 5 of these within the past 2 weeks
Mood Disorders, cont’ LO15.7 Describe how major depression differs from normal feelings of sadness or loneliness.
Symptoms of depression
Depressed mood
Reduced interest in almost all activities
Significant weight gain or loss
Sleeping too much or too little
Fatigue
Feelings of worthlessness or guilt
Reduced ability to think, concentrate
Recurrent thoughts of death
DSM IV requires 5 of these within the past 2 weeks

19. Mood Disorders, cont’ LO15
Mood Disorders, cont’ LO15.8 Explain the main features of bipolar disorder.
Bipolar disorder
A mood disorder in which episodes of depression and mania (excessive euphoria) occur

20. Mood Disorders, cont’ LO15
Mood Disorders, cont’ LO15.9 Discuss the four major factors that contribute to the onset of depression.
Vulnerability-stress model

21. Mood Disorders, cont’ LO15
Mood Disorders, cont’ LO15.9 Discuss the four major factors that contribute to the onset of depression.
Origins of depression
Genetic predispositions
Violence, childhood physical abuse, and parental neglect
Losses of important relationships
Cognitive habits

22. Mood Disorders, cont’ LO15
Mood Disorders, cont’ LO15.9 Discuss the four major factors that contribute to the onset of depression.
Biological theories of depression
5-HTT is a gene that is present in either a long or short form.
Genetics may also influence levels of serotonin and other neurotransmitters.

23. Mood Disorders, cont’ LO15
Mood Disorders, cont’ LO15.9 Discuss the four major factors that contribute to the onset of depression.
Violence and parental neglect
Repeated experiences with violence
Domestic violence
Children who are neglected are at an increased risk.

24. Mood Disorders, cont’ LO15
Mood Disorders, cont’ LO15.9 Discuss the four major factors that contribute to the onset of depression.
Relationship loss
History of separations and losses
Insecure attachment
Rejection by parents or peers

25. Mood Disorders, cont’ LO15
Mood Disorders, cont’ LO15.9 Discuss the four major factors that contribute to the onset of depression.
Cognitive habits
Depressed people believe their situation is permanent and uncontrollable.
Rumination: Brooding about negative aspects of one’s life

26. Personality Disorders LO15
Personality Disorders LO15.10 Explain the main features of borderline personality disorder.
Personality disorders
Borderline personality disorder
A disorder characterized by extreme negative emotionality and an inability to regulate emotions.
Antisocial personality disorder (APD)
Characterized by a lifelong pattern of irresponsible, antisocial behavior such as lawbreaking, violence, and other impulsive, restless acts.

27. Personality Disorders, cont’ LO15
Personality Disorders, cont’ LO15.12 List and explain the major factors that contribute to the central features of psychopathy.
Psychopathy
A personality disorder characterized by fearlessness; lack of empathy, guilt, and remorse; the use of deceit; and coldheartedness.
If caught in a lie or a crime, psychopaths may seem sincerely sorry but it is all an act.

28. Drug Abuse and Addiction LO15
Drug Abuse and Addiction LO15.12 List and explain the major factors that contribute to the central features of psychopathy.
Causes of APD
Abnormalities in the central nervous system
Impaired frontal-lobe functioning
Genetic influences
Environmental events

29. Drug Abuse and Addiction LO15
Drug Abuse and Addiction LO15.13 Discuss how the biological model of addiction would explain drug abuse and alcoholism.
Drug abuse and addiction
Biology and addiction
The biological model holds that addiction is due primarily to a person’s neurology and genetic predisposition.
Heavy use of drugs reduces the number of receptors and creates the feeling of having a compulsion to keep using the drug.

30. Drug Abuse and Addiction, cont’ LO15
Drug Abuse and Addiction, cont’ LO15.14 Discuss how the learning model of addiction would explain drug abuse and alcoholism.
Learning, culture, and addiction
Addiction patterns vary according to cultural practices.
Policies of total abstinence tend to increase addiction rates rather than reduce them.
Not all addicts have withdrawal symptoms when they stop taking a drug.
Addiction does not depend on properties of the drug alone but also on the reasons for taking it.

31. Drug Abuse and Addiction, cont’ LO15
Drug Abuse and Addiction, cont’ LO15.14 Discuss how the learning model of addiction would explain drug abuse and alcoholism.
Problems with drugs are more likely when a person. . .
has a physiological vulnerability to a drug.
believes he or she has no control over the drug.
is encouraged to take the drug in binges, and moderate use is neither tolerated nor taught.
comes to rely on the drug as a method of coping with problems, suppressing anger or fear, or relieving pain.
has a peer group using drugs or drinking heavily.

32. Drug Abuse and Addiction, cont’ LO15
Drug Abuse and Addiction, cont’ LO15.15 Explain the different predictions that the biological model and learning model would make regarding the benefits of total abstinence from versus moderate intake of alcohol.
Comparing biological and learning models
Differ in how they explain drug abuse and the solutions they propose.
Biological model says an addict must abstain from the drug forever. Learning model says problem drinkers can learn to drink in moderation.

33. Dissociative Identity Disorder LO15
Dissociative Identity Disorder LO15.16 Discuss the factors that make dissociative identity disorder a controversial diagnosis.
Dissociative identity disorder
A controversial disorder marked by the appearance within one person of two or more distinct personalities, each with its own name and traits
Commonly known as multiple personality disorder (MPD)

34. Dissociative Identity Disorder LO15
Dissociative Identity Disorder LO15.16 Discuss the factors that make dissociative identity disorder a controversial diagnosis.
MPD debate
First view
MPD is common but often unrecognized as such.
Starts in childhood as a means of coping.
Trauma produced a mental splitting.
Second view
Created through pressure and suggestion by clinicians.
Shift from handfuls of diagnoses to ten thousand diagnoses since 1980.

35. Dissociative Identity Disorder LO15
Dissociative Identity Disorder LO15.16 Discuss the factors that make dissociative identity disorder a controversial diagnosis.
MPD explained
MPD is an extreme form of our ability to present many aspects of our personalities to others.
MPD is a socially acceptable way for some troubled people to make sense of their problems.
Therapists looking for MPD may reward patients with attention and praise for revealing more and more personalities.

36. Schizophrenia LO15.17 Describe the five major symptoms of schizophrenia, and give an example of each.
Symptoms of schizophrenia
Bizarre delusions
Hallucinations and heightened sensory awareness
Disorganized, incoherent speech
Grossly disorganized and inappropriate behavior
Impaired cognitive abilities

37. Schizophrenia, cont’ LO15
Schizophrenia, cont’ LO15.17 Describe the five major symptoms of schizophrenia, and give an example of each.
Delusions and hallucinations
Delusions: False beliefs that often accompany schizophrenia and other psychotic disorders
Hallucinations: Sensory experiences that occur in the absence of actual stimulation

38. Schizophrenia, cont’ LO15
Schizophrenia, cont’ LO15.18 Describe the three main contributing factors to the origin of schizophrenia.
Genetic vulnerability

39. Schizophrenia, cont’ LO15
Schizophrenia, cont’ LO15.18 Describe the three main contributing factors to the origin of schizophrenia.
Prenatal or birth complications
Damage to the fetal brain increases chances of schizophrenia and other mental disorders.
May occur as a function of maternal malnutrition or illness.
May also occur if brain injury or oxygen deprivation occurs at birth.

40. Schizophrenia, cont’ LO15
Schizophrenia, cont’ LO15.18 Describe the three main contributing factors to the origin of schizophrenia.
Biological events during adolescence
Normal pruning of excessive synapses in the brain occurs during adolescence.
In schizophrenics, a greater number of synapses are pruned away.
May explain why first episode occurs in adolescence or early adulthood.