psychological disorders original content copyright by holt mcdougal. additions and changes to the...

Psychological Disorders

Original Content Copyright by HOLT McDougal. Additions and changes to the original content are the responsibility of the instructor.

Chapter 18: Psychological Disorders

Case Study: Not Guilty by Reason of Insanity

Section 1: Understanding Psychological Disorders

Section 2: Anxiety and Mood Disorders

Section 3: Dissociative and Somatoform Disorders

Section 4: Schizophrenia

Section 5: Personality Disorders

Lab: Applying What You’ve Learned



The majority of people with serious psychological disorders

are not dangerous to others. Some, however, commit

violent crimes. Of these, some are found not guilty by

reason of insanity and are sent to psychiatric institutions

instead of prison. When an accused person pleads insanity,

the prosecutor tries to prove that the person was sane at

the time of the crime and the defense tries to prove he or

she was not. Under law, one must be either all or nothing,

but in reality most psychological disorders are a matter of

degree.

Case Study: Not Guilty by Reason of Insanity



What do you think?

• In general, what criteria must a defendant meet to be ruled legally insane?

• Do you support the use of the insanity defense? Why or why not?



Understanding 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.

• Psychological disorders are classified in the Diagnostic and Statistical Manual of Mental Disorders, also known as the DSM.

Section 1 at a Glance



Reading Focus• What are psychological disorders, and how common are they?

• What are the four major symptoms that can help identify psychological disorders?

• How do psychologists classify psychological disorders?

Main Idea

Psychological disorders are relatively common. They cause personal suffering to millions of people and interfere with their ability to cope with everyday life.

Understanding Psychological Disorders



Why were people with mental illnesses seen as criminals?



• 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.

• The great majority of people are never admitted to mental hospitals and most people never seek the help of psychologists or psychiatrists.

• Estimates suggest that one in four American adults have experienced some type of psychological disorder.

• For people aged 15 to 44, psychological disorders are the leading cause of disability in the United States.

What Are Psychological Disorders?



Answer: Psychological disorders are uncommon.

Summarize

What is a common misconception about psychological disorders?

Reading Check



Click on the image to play the Interactive.



Typicality• Normality is determined by the degree to which a behavior is

average, or typical, of the majority of people.

– Scientific and artistic geniuses are not typical, but are not abnormal.

– People who are quite normal may have lifestyles that differ widely from the rest of the community.

• Additional measurements must be taken into account.

• People with psychological disorders usually do not differ much form so-called normal people.

• Certain behavior patterns and mental processes may suggest that an individual has a psychological disorder.

• Psychologists use several criteria to determine whether a person’s behavior indicates the presence of a psychological disorder.

Identifying Psychological Disorders



Maladaptivity

• Maladaptivity is a behavior that impairs an individual’s ability to function adequately in everyday life.

• Behavior that causes misery and distress rather than happiness and fulfillment, or that is dangerous

Emotional Discomfort

• Depression and anxiety cause extreme emotional discomfort.

• Helplessness, hopelessness, worthlessness, guilt, extreme sadness, and withdrawal

Socially Unacceptable Behavior

• Cultural context of a behavior must be taken into account.

• Culture-bound syndromes: clusters of symptoms



Answer: The four features are typicality, maladaptivity, emotional discomfort, and socially unacceptable behavior.

Find the Main Idea

What are four features that might indicate a psychological disorder?

Reading Check



Classification helps to determine:

• How many people have a given disorder

• What factors may be associated with a disorder

• Diagnosis and treatment

Classifying Psychological Disorders

• APA's classification system

• Used to communicate needs and treatment

• Modern categories based on observable signs and symptoms

DSM

• Anxiety

• Mood

• Dissociative

• Somatoform

• Schizophrenic

• Personality

Major Types of Disorders



Answer: disorders are no longer organized by presumed causes, categories have been added and removed, and the number of psychological disorders has grown

Summarize

What are some ways in which the DSM has been revised?

Reading Check



Culture-Bound Syndromes

In certain cultures, one can find combinations of psychiatric and physical

symptoms recognized as disease only in that culture. These are often treated

with folk remedies.

Cultural Diversity and Psychology

• Hikikomori: Japanese people who have withdrawn from social life

• Latah: In Malaysia, a person who has a severe reaction to being startled. When surprised, latahs mimic the speech of those around them and obey any order

• Ghostsickness: Navajo illness with symptoms of bad dreams, loss of appetite, feeling of suffocation, hallucinations, fainting, and terror

• Hwa-byung: In Korea, a name for physical symptoms that arise from the suppression of anger

• Amok: In Malaysia, a previously peaceful man who suddenly tries to kill or injure others

• Susto: some Hispanics; the experience of acute unhappiness following a frightening event

• Zar: Middle East and North Africa, women laugh and bang heads



Thinking Critically• What are some of the physical symptoms associated with

culture-bound syndromes?

• Do you think Western medical schools should include culture-bound syndromes in their psychiatry programs? Why or why not?



Anxiety and Mood Disorders

• Anxiety disorders occur when people feel fear or nervousness out of proportion to the actual threat.

• Mood disorders are characterized by mood changes that are inappropriate for the situation to which they are responding.




Reading Focus• What are some characteristics of anxiety?

• What are five major types of anxiety disorders?

• How do psychologists explain anxiety disorders?

• How do the two main types of mood disorders compare?

• Which theories explain the origins of mood disorders?

Main Idea

Anxiety disorders cause people to experience irrational or excessive fear. Mood disorders cause people to experience mood changes that are inappropriate to the situation.

Anxiety and Mood Disorders



Why does an English soccer star need three refrigerators?



• Anxiety refers to a generalized state of dread or uneasiness that occurs in response to a vague or imagined danger, as opposed to fear, which is a response to a real danger or threat.

– Characterized by

• Nervousness

• Inability to relax

• Concern about losing control

• Trembling

• Sweating

• Rapid heart rate

• Shortness of breath

• Increased blood pressure

• Everyone feels anxious at times, but constant anxiety can interfere with effective living.

What Is Anxiety?



Answer: constant anxiety, out of proportion to event, interferes with normal effective living

Analyze

How are anxiety disorders different from normal anxious reactions?

Reading Check



Phobic Disorder• Phobia: derives from the Greek root phobos, which means “fear”

• Specific phobia is the most common of all anxiety disorders and refers to a persistent excessive fear of a particular object or situation.

– Most common include

• Zoophobia: fear of animals

• Claustrophobia: fear of enclosed spaces

• Acrophobia: fear of heights

• Arachnophobia: fear of spiders

• Social phobia is characterized by persistent fear of social situations in which one might be exposed to the scrutiny of others.

Types of Anxiety Disorders



Generalized Anxiety Disorder• An excessive or unrealistic worry about life circumstances that lasts

for at least six months.

– Few people seek treatment because it does not differ, except in intensity and duration, from the normal worries of everyday life.

Panic Disorder and Agoraphobia• People with panic disorder have recurring and unexpected panic

attacks, or relatively short periods of intense fear or discomfort characterized by shortness of breath, dizziness, rapid heart rate, trembling, choking, etc.

• Agoraphobia: the fear of being in places or situations in which escape may be difficult or impossible such as crowded public places.

– Many people with agoraphobia develop panic attacks when in public.



Stress Disorders• Include post-traumatic stress disorder (PTSD) and acute stress

disorder

– Similar symptoms, but PTSD is more severe and longer-lasting

– PTSD occurs after rape, abuse, severe accident, natural disasters, and war atrocities.

Obsessive-Compulsive Disorder (OCD)• Obsessions are unwanted thoughts, ideas, or mental images that

occur over and over again, and most people try to ignore or suppress them.

• Compulsions are repetitive ritual behaviors, often involving checking or cleaning something.

• People are usually aware that the obsessions are unjustified, which distinguishes obsessions from delusions.



Answer: phobic, panic, generalized anxiety, obsessive-compulsive, stress

Summarize

What are the five types of anxiety disorders?

Reading Check



Psychological Views

• Psychoanalytic views are no longer widely accepted, but have affected the classification of psychological disorders.

• Learning theorists believe that phobias are learned in childhood.

• Cognitive theorists believe that people make themselves feel anxious by responding negatively to most situations.

Biological Views

• Heredity may play a role

• Studies of twins indicate that having a parent or sibling with a disorder increases the chance an individual will have a disorder.

• Some psychologists believe that people who rapidly acquired strong fears of real dangers would be more likely to live and reproduce.

Interaction of Factors: some cases reflect the interaction of biological

and psychological factors.

Explaining Anxiety Disorders



Answer: Phobias are learned in childhood, conditioned phobias remain; people avoid situations that lead to anxiety related to the phobia.

Find the Main Idea

How do learning theorists explain anxiety disorders?

Reading Check



• Most people have mood changes that reflect the normal ups and downs of life, but mood changes that are inappropriate to a situation can signal a mood disorder.

• Two types: depression and bipolar disorder

Bipolar Disorder

• A cycle of mood changes from depression to wild elation and back again

• Period of mania, or extreme excitement characterized by hyperactivity and chaotic behavior

Major Depression

• Feelings of helplessness, hopelessness, worthlessness, guilt, and great sadness

• The DSM-IV contains a list of symptoms to help diagnose

Postpartum Depression

• Some women suffer symptoms of depression after giving birth

• Can harm both mother and child

Types of Mood Disorders



Answer: persistent depressed mood, loss of interest in activities, significant weight loss or gain, sleeping more or less, fatigue, reduced ability to concentrate or make meaningful decisions, recurrent thoughts of death or suicide

Analyze

What are some ways that mood disorders can disrupt one’s daily life?

Reading Check



• Psychological Views

– The psychoanalytic view of depression connects the past to the present.

– Learning theorists: “learned helplessness” makes people prone.

– Cognitive theorists: habitual style of explaining life events.

• Attribution theory: people assign different types of explanations to events, which affect self-esteem and self-efficacy.

• Beck suggests that people who are depressed have a negative view of themselves, their experiences, and their future.

• Biological Views

– Mood disorders occur more often in the close relatives of affected individuals than they do in the general population.

– Two neurotransmitters in the brain—serotonin and noradrenaline—may partly explain the connection between genes and mood.

• Biological and Psychological Factors

– A combination of factors is most likely at work.

Explaining Mood Disorders



Answer: Dogs learned that they could not prevent the pain of shocks. Theorists have applied this to human beings, suggesting that once people believe that they cannot change a situation, they will make no effort to do so.

Explain

How was Martin Seligman’s experiment with dogs related to theories about mood

disorders?

Reading Check



Post-Traumatic Stress Disorder and Iraq War Veterans

For those who survive the horrors of war, the trauma of combat may not be left

behind on the battlefield. Some veterans report vivid flashbacks and

nightmares.

Current Research in Psychology

• A high incidence of PTSD has been reported among soldiers returning from war in Iraq and Afghanistan.

• Researchers are seeking reasons for what some call a PTSD epidemic.

• Younger veterans are more likely to be diagnosed.

• Those with traumatic head injuries more likely to be diagnosed.

• Currently veterans can receive five years of free health care for any mental disorder related to combat.

• Because PTSD shows up long after the trauma, increased mental health services will be necessary.



Thinking Critically• Why do you think younger veterans are more likely to be

diagnosed with PTSD?

• Given the current research on PTSD, what steps do you think the U.S. Department of Veterans Affairs should take to deal with the effects of PTSD in returning soldiers?



Dissociative and Somatoform Disorders

• Dissociative disorders are characterized by the separation of certain personality components or mental processes from conscious thought.

• Somatoform disorders are expressed in the form of actual physical symptoms.




Reading Focus• What is dissociation, and what are the four dissociative disorders?

• How do theorists explain the origins of dissociative disorders?

• What is somatization, and what are the most common types of somatoform disorders?

• How do theorists explain the origins of somatoform disorders?

Main Idea

Dissociative disorders cause people to lose their memory or identity. Somatoform disorders cause people to express psychological distress through physical symptoms.

Dissociative and Somatoform Disorders



How could a man forget his entire life?



Dissociative Amnesia• Characterized by a sudden loss of memory, usually following a

particularly stressful or traumatic event.

• It cannot be explained biologically.

• The incidence of dissociative amnesia rises markedly during wartime and natural disasters.

• Dissociation: the separation of certain personality components or mental processes from conscious thought

• In some situations, it is normal (becoming engrossed in a book).

• If dissociation occurs as a way to avoid stressful events or feelings, it can signal a disorder.

Dissociative Disorders



Dissociative Fugue

• Characterized by not only forgetting personal information and past events but also by suddenly relocating from home or work and taking on a new identity.

• Individuals may appear healthy until the fugue ends, when they will not remember anything that happened during the fugue.

Dissociative Identity Disorder

• Involves the existence of two or more personalities within a single individual. The various personalities may or may not be aware of the other.

Depersonalization Disorder

• Depersonalization: feelings of detachment from one’s mental processes or body

• People describe being outside their bodies.



Answer: involve separation of personality components or mental processes from conscious thought

Compare

What is the basic feature that dissociative disorders have in common?

Reading Check



• Psychoanalytic theory suggests people dissociate in order to repress unacceptable urges.

• Learning theorists claim individuals have learned not to think about disturbing events in order to avoid feelings, of guilt, shame, or pain.

• Cognitive and biological theorists have not offered a complete explanation of dissociative disorders.

Explaining Dissociative Disorders



Answer: learning theory

Summarize

Which type of theories can explain dissociative disorders?

Reading Check



Somatization: the expression of psychological distress through

physical symptoms. People with somatoform disorders have

psychological problems (such as depression) but experience

inexplicable physical symptoms (such as paralysis).

• Patients experience a change in or loss of physical functioning in a major part of the body for which there is no known medical explanation

• Patients often show a lack of concern for their symptoms.

Conversion Disorder

Somatoform Disorders

• A person’s unrealistic preoccupation with thoughts that he or she has a serious disease.

• Patients may become absorbed by minor physical symptoms and sensations.

Hypochondriasis



Answer: conversion disorder, hypochondriasis

Summarize

What are the two main types of somatoform disorders?

Reading Check



• Explanations are primarily psychological.

• Psychoanalytic theory suggests disorders occur when individuals repress emotions associated with forbidden urges and instead express them symbolically in physical symptoms.

• Other psychologists have argued that people with conversion disorder “convert” psychological stress into actual medical problems.

• Behavioral theorists have suggested that somatoform symptoms can serve as a reinforcer if they successfully allow a person to escape from anxiety.

• There is some evidence that biological or genetic factors may play a role.

Explaining Somatoform Disorders



Answer: Possible answer—The mind can have a powerful effect on the body.

Analyze

What does it mean to convert psychological stress into an actual physical problem?

Reading Check



Schizophrenia

• Schizophrenia is usually considered the most serious psychological disorder and can be very disabling.

• Schizophrenia is characterized by a loss of contact with reality.

• The three types of schizophrenia are paranoid, disorganized, and catatonic schizophrenia.




Reading Focus• What are the basic symptoms of schizophrenia?

• What are the three major types of schizophrenia?

• How do psychological and biological explanations of schizophrenia differ?

Main Idea

Schizophrenia is the most serious psychological disorder, causing thought disruption and a decreased ability to function normally.

Schizophrenia



What can paintings of cats reveal about a human mind?



• Schizophrenia: characterized by loss of contact with reality.

– Can be very disabling and can lead to the affected person’s inability to function independently

– First appears in young adulthood

– Usually develops gradually, but can also appear suddenly

• Most striking symptoms are:

– Hallucinations

– Delusions

– Thought disorders

• Other symptoms include social withdrawal, impaired social skills, loss of normal emotional responses.

• Occasionally, may go into a catatonic stupor: an immobile, expressionless, comalike state.

What Is Schizophrenia?



Answer: loss of contact with reality

Summarize

What is the basic characteristic of schizophrenia?

Reading Check



Paranoid Schizophrenia

• Delusions or frequent auditory hallucinations that center on one theme, often a theme of persecution

Disorganized Schizophrenia

• Incoherent in their thought and speech and disorganized in their behavior; delusions and hallucinations are unconnected

• Emotionless or show inappropriate emotions

Catatonic Schizophrenia

• Activity may slow to a stupor and then suddenly switch to agitation

• May hold unusual, uncomfortable body positions for long periods of time, even after their arms and legs swell and stiffen

Types of Schizophrenia



Answer: paranoid, disorganized, and catatonic schizophrenia

Summarize

What are the three types of schizophrenia?

Reading Check



Psychological Views

• Result of overwhelming of the ego by urges from the id.• Fantasies become confused with reality.• Family environment may spur disease, but does not cause it.

Biological Views

• Studies try to link abnormal brain functioning and structure with specific symptoms.

• Heredity, complications during pregnancy and birth, and birth during winter were all shown to affect rates of schizophrenia.

Multifactorial Model

• Biological and psychological factors may interact in development.

• The model suggests that even severely dysfunctional environmental factors are not enough to lead to the disease.

Explaining Schizophrenia



Answer: evidence of differences in size and structure of the brain, more dopamine use, genetic factors

Analyze

What are some indications that schizophrenia has a physical basis?

Reading Check



Personality Disorders

• Personality disorders are patterns of inflexible traits that disrupt social life or work and may distress the affected individual.

• Four common personality disorders are paranoid, schizoid, antisocial, and avoidant.




Reading Focus• What are personality disorders, and how do they differ from other

psychological disorders?

• What are ten types of personality disorders?

• How do psychological and biological views explain the origins of antisocial personality disorder?

Main Idea

Personality disorders are characterized by patterns of unchanging personality traits that disrupt people’s social lives and work lives.

Personality Disorders



Why does Lisa demand so much attention?



• Personality disorders: patterns of inflexible traits that disrupt social life or work and may distress the affected individual

• An enduring pattern of inner experience and behavior that deviates markedly from the expectations of the culture of the individual who exhibits it

• Usually show up by late adolescence

• Psychological disorders are illnesses that an individual experiences as episodes. In contrast, personality disorders are enduring traits that are major components of the individual’s personality.

What Are Personality Disorders?



Answer: Personality disorders are patterns of inflexible, enduring traits, not episodes of illness.

Contrast

How are personality disorders different from other disorders that they may resemble?

Reading Check



Answer: Individuals with personality disorders have great difficulty making friends and developing lasting relationships with others, and it is difficult for them to retain or achieve success in a job, which can lead to further isolation or financial hardship.

Analyze

What are some ways that personality disorders can make life difficult?

Reading Check



Both psychological and biological theories have been

suggested to explain some of them.

• Psychoanalytic theory suggests a lack of guilt underlies the antisocial personality.

• Learning theorists suggest children who are not reinforced for good behavior learn antisocial behavior.

• Cognitive theorists argue antisocial teens use a faulty view of others’ actions.

Psychological Views

Explaining Personality Disorders

• Antisocial personality disorder appears to run in families.

• Some evidence suggests that antisocial people have less developed emotional centers in their brains.

• Biological factor by itself is unlikely to cause the development of antisocial personality disorder.

Biological Views



Answer: If rejected, punished harshly, raised with a lack of affection, or lack appropriate role models, children may develop an antisocial personality disorder.

Analyze

How may childrearing affect the development of antisocial personality

disorder?

Reading Check



Diagnosing Psychological Disorders

Can you diagnose a psychological disorder based on a

written description of someone’s symptoms?

• In this lab, you will work in groups to review one of the six types of disorders you have learned about.

• With your group, conduct additional research to write a fictional case study.

1. Introduction

Lab: Applying What You’ve Learned

• Select two specific disorders

• Ensure your case study has each of the pieces on the sample case study illustrated.

2. Writing the Case Studies



• Someone from each group should share the main points about the type of disorder assigned to their group.

• Listen to your teacher read each case study aloud.

• Jot down your diagnosis.

• As a class, vote for which psychological disorder was described.

3. Diagnosing the Disorders

Lab (cont'd.)

• As a class, discuss the following:

• How successful was the class at diagnosing the psychological disorders described?

• Were some disorders particularly easy to diagnose? Or particularly hard?

• How would this lab have been different if some of the case studies had described multiple disorders?

4. Discussion

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