1. Psychological disorders
chapter 11
Psychological disorders

2. Overview Defining and diagnosing disorder Anxiety disorders
chapter 11
Overview
Defining and diagnosing disorder
Anxiety disorders
Mood disorders
Personality disorders
Drug abuse and addiction
Dissociative identity disorder
Schizophrenia

3. Dilemmas of definition
chapter 11
Dilemmas of definition
Possible models for defining disorders
As the violation of cultural standards
As emotional distress
As behavior harmful to oneself or others

4. chapter 11
Mental disorder
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

5. chapter 11
Your turn
Psychopaths are often happy, functional people, but they manipulate and harm others without conscience. On what basis are psychopaths said to have a mental disorder?
A mental disorder is any behavior or mental state that
(1) causes a person to suffer, is self-destructive;
(2) seriously impairs the person’s ability to work or get along with others;
(3) or endangers others or the community.

6. chapter 11
Your turn
Psychopaths are often happy, functional people, but they manipulate and harm others without conscience. On what basis are psychopaths said to have a mental disorder?
A mental disorder is any behavior or mental state that
(1) causes a person to suffer, is self-destructive;
(2) seriously impairs the person’s ability to work or get along with others;
(3) or endangers others or the community.

7. Diagnostic and Statistical Manual
chapter 11
Diagnostic and Statistical Manual
Axis I: Primary clinical problem
Axis II: Personality disorders
Axis III: General medical conditions
Axis IV: Social and environmental stressors
Axis V: Global assessment of overall functioning

8. Explosion of mental disorders
chapter 11
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.

9. Concerns about diagnostic system
chapter 11
Concerns about diagnostic system
The danger of over-diagnosis
The power of diagnostic labels
Confusion of serious mental disorders with normal problems
The illusion of objectivity and universality

10. chapter 11
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.
The DSM-IV included for the first time a list of culture-bound syndromes.

11. Projective tests Projective tests Rorschach inkblot test
chapter 11
Projective tests
Projective tests
Psychological tests used to infer a person’s motives, 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

12. Objective tests MMPI Inventories
chapter 11
Objective tests
Inventories
Standardized objective questionnaires requiring written responses
Typically include scales on which people are asked to rate themselves
MMPI
Most widely used personality instrument
Clinical and employment settings
Measures aspects of personality that, if extreme, suggest a problem

13. Generalized anxiety disorder
chapter 11
Generalized anxiety disorder
Continuous state of anxiety marked by feelings of worry and dread, apprehension, difficulties in concentration, and signs of motor tension

14. Posttraumatic stress disorder
chapter 11
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 the trauma, and increased physiological arousal
Diagnosed only if symptoms persist for six months or longer
May immediately follow event or occur later

15. chapter 11
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

16. Fears and phobias Phobia
chapter 11
Fears and phobias
Phobia
An exaggerated, unrealistic fear of a specific situation, activity, or object

17. chapter 11
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.

18. Obsessive-compulsive disorder
chapter 11
Obsessive-compulsive disorder
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.

19. chapter 11
Your turn
If you have the persistent thought that gremlins are sabotaging any airplane you are on or will be on, then you have a _____. If you cannot stop asking for more water during flights, then you have a _____.
1. Obsession; compulsion
2. Compulsion; obsession
3. Phobia; obsession
4. Plane ticket; pet camel

20. chapter 11
Your turn
If you have the persistent thought that gremlins are sabotaging any airplane you are on or will be on, then you have a _____. If you cannot stop asking for more water during flights, then you have a _____.
1. Obsession; compulsion
2. Compulsion; obsession
3. Phobia; obsession
4. Plane ticket; pet camel

21. Depression Major depression
chapter 11
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)

22. Symptoms of depression
chapter 11
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

23. chapter 11
Bipolar disorder
A mood disorder in which episodes of depression and mania (excessive euphoria) occur.

24. Biological theories of depression
chapter 11
Biological theories of depression
Studies of adopted children support genetic explanations of depression
5-HTT is a gene that is present in either a long or short form.
17% of individuals with the long form become severely depressed.
43% of individuals with 2 copies of the short form become depressed.
Genetics may also influence levels of serotonin and other neurotransmitters.

25. Life experiences and circumstances
chapter 11
Life experiences and circumstances
Social explanations emphasize the stressful circumstances in people’s lives.
Loss of or problems with important relationships
Psychologists investigating sex differences in depression have ruled out hormones and genetics and are now investigating life circumstances. Women are less satisfied with work and family and more likely to live in poverty.

26. chapter 11
Cognitive habits
Cognitive explanations emphasize habits of thinking and ways of interpreting events.
Depressed people believe their situation is permanent, uncontrollable.
Rumination
Brooding about negative aspects of one’s life

27. Problem personalities
chapter 11
Problem personalities
Personality disorder
Rigid, maladaptive patterns that cause personal distress or an inability to get along with others
Paranoid personality disorder
Characterized by habitually unreasonable and excessive suspiciousness and jealousy
Narcissistic personality disorder
Characterized by an exaggerated sense of self-importance and self-absorption

28. Criminals and psychopaths
chapter 11
Criminals and psychopaths
Antisocial personality disorder
Characterized by a lifelong pattern of irresponsible, antisocial behavior such as lawbreaking, violence, and other impulsive, restless acts
Psychopathy
Characterized by a lack of remorse, empathy, anxiety, and other social emotions; the use of deceit and manipulation, and impulsive thrill seeking

29. Causes of APD and psychopathy
chapter 11
Causes of APD and psychopathy
Abnormalities in the central nervous system
Impaired frontal-lobe functioning
Genetic influences

30. chapter 11
Biology and addiction
The biological model holds that addiction is due primarily to a person’s biochemistry, metabolism, and genetic predisposition.
More evidence comes from twin studies.

31. chapter 11
The addicted brain

32. Learning, culture, and addiction
chapter 11
Learning, culture, and addiction
Addiction patterns vary according to cultural practices and the social environment.
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 depends on both the drug and the reason for taking it.

33. Dissociative identity disorder
chapter 11
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

34. The MPD controversy First view Second view
chapter 11
The MPD controversy
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
Handfuls to ten thousand since 1980

35. Sociocognitive explanation
chapter 11
Sociocognitive explanation
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. Symptoms of schizophrenia
chapter 11
Symptoms of schizophrenia
Bizarre delusions
Hallucinations and heightened sensory awareness
Disorganized, incoherent speech
Grossly disorganized and inappropriate behavior
Impaired cognitive abilities

37. Delusions and hallucinations
chapter 11
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. Genetic vulnerability
chapter 11
Genetic vulnerability
The risk of developing schizophrenia increases as the genetic relatedness with a diagnosed schizophrenic increases.

39. Structural brain abnormalities
chapter 11
Structural brain abnormalities
Several abnormalities exist, especially when disease has primarily negative symptoms.
Decreased brain weight
Decreased volume in temporal lobe or hippocampus
Enlargement of ventricles
About 25% do not have these observable brain deficiencies.

40. Neurotransmitter abnormalities
chapter 11
Neurotransmitter abnormalities
Include serotonin, glutamate, dopamine
Many schizophrenics have high levels of brain activity in areas served by dopamine, and greater numbers of dopamine receptors.
Similar abnormalities are found in depression and alcoholism.

41. Prenatal or birth complications
chapter 11
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

42. Adolescent abnormalities in brain development
chapter 11
Adolescent abnormalities in brain development
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