Chapter Fourteen

Psychological Disorders

Try the Tutorial!

What is abnormal?
(Look for a number of these criteria.)

• Unusual or infrequent behavior

• Socially unacceptable behavior (Consider cultural differences!)

• Faulty perception of reality (e.g. hallucinations or delusions)

• Personal distress

• Self-defeating behavior (causes misery)

• Dangerous Behavior

Perspectives on Abnormal Behavior

• Demonology

– “The devil made me do it!”

• Medical Model

– Biological or Organic Version

– Psychodynamic Version

• Humanistic-existential Perspective

– roadblocks in the self actualization process.

• Learning Perspectives

– Leads to behavior therapies

• Cognitive Perspective

– It’s all in the mind!

– Ellis & irrationality

• Sociocultural Perspective

– “Society drives men mad.”

• Some are eclectic!

Classifying Abnormal Behavior

• Diagnostic & Statistical Manual of Mental Disorders (DSM) See page 519.

• By the American Psychiatric Association

• Currently in its 4th edition.

• Defines what is a mental illness.

• Not everyone likes it.

• See: The Myth of Mental Illness by Thomas Szasz, M.D.

• Note that “insanity” is a legal term. (p. 516)

Anxiety Disorders
Most Common Disorders (24 million Americans)

• Phobias - Intense, irrational fears.

– Social phobia (p. 523)

– Agoraphobia – a widespread phobia

• Panic Disorder - recurrent panic attacks

• Generalized Anxiety Disorder

– must persist for six months

• Obsessive Compulsive Disorder (OCD)

– See page 524.

• Post-traumatic Stress Disorder (PTSD)

• Acute Stress Disorder – Occurs within a month and lasts 2 days to 4 weeks.

Dissociative Disorders

- sudden, temporary changes in consciousness or self-identity

• Dissociative Amnesia - loss of memory (previously called psychogenic amnesia)

• Dissociative Fugue - three symptoms

– Moving, amnesia & new identity

• Dissociative Identity Disorder

– formerly known as MPD - See p. 528.

– Does it really exist or is it only “malingering?”

See p. 529 for theoretical views.

Somatoform Disorders
(Having to do with the body)

• “Disorders in which people complain of physical (somatic) problems, even though no physical abnormalities can be found.”

• Conversion Disorder - Formerly called “hysterical neuroses” in Freud’s day.

– Rare and short in duration.

– Patient may display la belle indifference.

• Hypochondriasis

– the persistent belief that one has a medical disorder despite lack of medical findings.

Mood Disorders

• Depression - “common cold” of disorders.

– 10% of population at any time.

– also called “dysthymia.”

– Freud called this “neurotic depression.”

• Major Depressive Disorder

– Patient may show impaired reality testing i.e. psychotic behaviors, delusions of unworthiness, & psychomotor retardation.

• Bipolar Disorder

– manic phase: elated, excited, poor judgment, pressured speech, rapid flight of ideas.

– Followed by depressed phase.

Theories of Depression

• Psychoanalytic - “Anger turned inward.”

• Biological factors- serotonin and/or glutamate imbalance. The inheritability of “neuroticism,” p. 535.

• Learned Helplessness - Seligman

• Social Learning Theory - “a lack of social skills” & external locus of control

• Psychosocial factors - (See p. 533 re: The Case of Women & Depression.)

• Cognitive factors - e.g. perfectionism, rumination and attributional style

Schizophrenia

• NOT split personality! Characterized by disturbances in:

– thought & language

– perception & attention

– motor activity

– mood

– withdrawal & absorption in daydreams or fantasy

Types of Schizophrenia

• See pages 537- 538.

• Disorganized Type - characterized by disorganized delusions and vivid hallucinations.

• Paranoid Type - most common type. Characterized by delusions of persecution, grandeur, & reference.

• Catatonic Type - (rare) - striking impairment in motor activity. May show waxy flexibility and mutism (refusal to talk).

Theoretical Views of Schizophrenia (See p. 538)

• Psychodynamic view - overwhelming of the ego by the id

• Learning view - conditioning & observational learning

• Genetic factors - runs in families. Not the sole factor.

• Dopamine theory - utilize more dopamine

• Sociocultural view - most common among the poorest & the heart of the inner cities.

• Multifactorial view – See Figure 14.2, page 540

Personality Disorders

• Paranoid personality disorder

– Persistent suspiciousness

• Schizotypal personality disorder

– Oddities of thought and behavior

• Schizoid personality disorder

– Social withdrawal

• Antisocial personality disorder

– Frequent conflict with society

• Avoidant personality disorder

– Unwilling to enter relationships because of fears of rejection

Suicide - See pp. 545-547.

• Man Against Himself - (famous book); by Karl Menninger, M.D.

• To prevent suicide, consider it a medical emergency and:

– Draw the person out.

– Be empathetic.

– Suggest alternatives.

– Ask about means (I.e. how they will do it).

– Get professional help. . . NOW!

– Extract a promise.

– Do not insult or challenge.