Psychological DisordersPsychological Disorders

Chapter 16Chapter 16

Section 1What are Psychological

Disorders?

• Define psychological disorder

• Distinguish between the concepts of normality and abnormality

Exploring Psychology

• Read p. 447– Who is right? The prophet or the police officers?– Abnormal or normal behavior?

• Many believe that having visions and hearing voices are important religious experiences

• Others believe that these are symptoms or psychological disorders

• Mountain man was interviewed by psychiatrists and diagnosed as a paranoid schizophrenic and hospitalized

• If he had stayed at home people would have continued to see him as perfectly normal

Defining & Identifying Psychological Disorders

• In the example, the man was classified as mentally troubled bcs his behavior was so different

• The fact that a person is different does not necessarily mean that he is suffering from a mental illness– Going along w/ a crowd can be self-

destructive

Distinguishing Normal From Abnormal

• Deviance

• Adjustment

• Psychological Health

Deviation From Normality

• One approach of defining normality is to say that whatever most people do is normal

• Abnormality then is any deviation from the average

Normal Abnormal

• Bathing periodically

• Expressing grief at the death of a loved one

• Wearing warm clothes when going out in the cold

• Taking 10 showers a day

• Laughing when a loved one dies

• Wearing a bathing suit in the snow

Limitations of Deviance Approach

• If most people cheat on their income-tax returns are honest taxpayers abnormal?

• If most people are noncreative was Shakespeare abnormal

• Different cultural norms must also be taken into consideration

Hysteria• Sometimes lack of knowledge leads to

nonsensical explanations for psychological phenomena

• Hysteria- comes from the Greek word for “uterus”

• Ancient Greeks diagnosed women with mental disorders by using the “wandering uterus” theory

• In the Middle Ages this theory was used to explain demonic possession and led to persecutions of women for witchcraft

Adjustment• Normal- able to get along in the world

physically, emotionally, and socially– Can feed and clothe themselves, work, find

friends, & live by the rules of society

• Abnormal- fails to adjust– May be so unhappy that they refuse to eat– May be so lethargic that they cannot hold a job– May experience so much anxiety in

relationships that they end up avoiding others

• Not all people w/ psy disorders are violent, destructive, or isolated

• Sometimes a person’s behavior may only seem normal

• Behavior that is socially acceptable in one society may not be acceptable in another– Cultural context of a behavior must be

taken into consideration

Psychological Health• Normal- a healthy person would be one

who is functioning ideally or who is at least striving toward ideal functioning

• Personality theorists such as Carl Jung and Abraham Maslow described this striving process as self-actualization– Normal- involves full acceptance and

expression of one’s own individuality and humanness

Problems

• Difficult to determine whether or not a person is doing good job of actualizing himself– How can you tell when a person is doing

his best– How can you tell if he is struggling

• Answers to such questions are often arbitrary

The Mentally Ill Label

• Some theorists conclude that labeling a person as mentally ill simply bcs his behavior is odd is a mistake as well as cruel and irresponsible

• Thomas Szasz- foremost proponent of this belief

Thomas Szasz• Argued that most of the people whom we

call mentally ill are simply having “problems in the living” that cause serious conflicts with the world around them

• Stated that instead of dealing with the patient’s conflicts as things that deserve attention and respect, psychiatrists simply label them as sick and shut them in hospitals

• Society’s norms remain unchallenged and psychiatrists remain in a comfortable position of authority

• The ones who lose are the patients who by being labeled abnormal and are deprived of responsibility for their behavior and of their dignity as human beings

• He claimed that the result would be an increase in the patients’ problems

Szasz Refuted• Most psychologists and psychiatrists would

agree that a person who claims to be Napoleon or God is truly abnormal and disturbed

• The fact that abnormality is difficult to define does not mean that it does not exist

IMPORTANT

• We should be very cautious about judging a person to be mentally ill just bcs he/she acts in a way that we cannot understand

• Keep in mind that mild psychological disorders are common

• Only when a psychological problem bcms severe enough to disrupt everyday life that is it thought as an abnormality or illness

The Problem of Classification• For years psychiatrists have been trying to

devise a logical and useful method for classifying emotional disorders– The causes and symptoms of psychological

disturbances and breakdowns are rarely obvious

• All major classification schemes have accepted that the medical model - that abnormal behavior can be described in the same manner as any physical illness

DSM

• 1952- the American Psychiatric Association published the Diagnostic and Statistical Manual of Mental Disorders

• Revised 4 times- DSM-II (1968), DSM-III (1980), DSM-III- Revised (1987), DSM-IV (1994), minor text revision DSM-IV-TR (2000)

• Major changes occurred in shifts from DSM-II to DSM-III-R

– Before 1980 the 2 most commonly used diagnostic distinctions were neurosis and psychosis

– Conditions expanded into more detailed categories including- anxiety disorders, somatoform disorders, dissociative disorders, mood disorders, & schizophrenia

Major Psychological Disorders of Axis I

• Page 452

Section 2Anxiety Disorders

• Objectives

– Identify the behavioral patterns that psychologists label as anxiety disorders

– Explain what causes anxiety disorders

Anxiety• A general state of dread or uneasiness that a person

feels in response to a real or imagined danger

• People w/ an anxiety disorder suffer intense anxiety that is out of proportion to the situation provoking it

• 15% of adults have endured symptoms typical of anxiety disorders

• These disorders share certain characteristics – Feelings of anxiety and personal inadequacy– Avoidance of dealing with problems

• Often have unrealistic images of themselves

• Seem unable to free themselves of recurring worries and fears

• Emotional problems may be expressed in varying ways– Constant worrying– Sudden mood swings– Physical symptoms- headaches, sweating,

muscle tightness, weakness, & fatigue• Anxious people often have difficulty forming

stable and satisfying relationships• Even though their behavior is often self-

defeating and ineffective in solving problems, but the often refuse to give up their behavior for more effective methods

DSM-IV

• Anxiety disorders include– Generalized anxiety disorder– Phobic disorder– Panic disorder– Obsessive-compulsive disorder– Post-traumatic stress disorder

Generalized Anxiety Disorder• Severely anxious person almost always feels

nervous- a vague feeling that one is in danger

• This anxiety could blossom into a full-fledged panic attack– Choking sensations– Chest pain– Dizziness– Trembling– Hot flashes

• Fear- reaction to real and identifiable threats

• Anxiety - reaction to vague or imagined dangers

• Some people experience a continuous generalized anxiety

• Fearing the unknown they are unable to make decisions or enjoy life

Living with Anxiety

• Become so preoccupied with their internal problems that they neglect social relationships– Often have trouble dealing with family and friends

and fulfilling their responsibilities which adds to their anxiety

• Vicious cycle- the more they worry, the more difficulty they have, the more difficulty they have, the more they worry

Physical Symptoms

• Muscular tension• Inability to relax• Furrowed brow• Strained face

• Poor appetite• Indigestion• Diarrhea• Frequent urination

Difficulty sleeping or waking up suddenly at night

Why are people anxious?• 1- Role of learning

– If a man feels anxious during a date, the thought of another date could cause anxiety, he may then learn to avoid dating

• 2- Partly inherited

• 3- Environmental Factors– Unpredictable traumatic experience

• Such a disorder usually occurs following a major life change

• Uncertainties of modern life may help explain the high incidence of generalized anxiety

Phobic Disorder

• Severe anxiety if focused on a particular object, animal, activity, or situation that seems out of proportion to the real dangers involved

• Specific Phobias• Social Phobias• Agoraphobia

Specific Phobia

• Phobia focused on almost anything including high places (acrophobia), enclosed spaces (claustrophobia), and darkness (nyctophobia)

Social Phobia

• Victims fear that they will embarrass themselves in a public place or social situation

• Speaking in public, eating in public, using public restrooms, meeting strangers, going on a first date

Agoraphobia• Extreme fear of being in a public place

– The fear of open spaces

• May stop going to movies or shopping in large, busy stores

• Some reach the point where they cannot leave their neighborhood or house

• Phobias range in intensity form mild to extremely severe

• Most people deal with phobias by avoiding the thing that frightens them

• The phobias are learned and maintained by reinforcing effects of avoidance– Reduces anxiety but not the phobia

• One form of treatment involves providing the phobic person with opportunities to experience the feared object under conditions in which he or she feels safe

Panic Disorder

• Panic- feeling of sudden, helpless terror, such as the overwhelming fright one might experience when cornered by a predator

Panic Attack

• Victim experiences sudden and unexplainable attacks of intense anxiety leading to a feeling of of inevitable doom or even the fear that he or she is about to die

Symptoms of a Panic Attack

• Symptoms vary but may include– Sense of smothering– Choking– Difficulty breathing– Faintness or dizziness– Nausea– Chest pains

• Although panic attacks can last for an hour or more, they usually last just a few minutes

• Occur without warning• May be inherited• Panic victims usually experience the first

attack shortly after a stressful event• Disorder may also be the result of

interpreting physiological arousal such as an increased heart rate as disastrous

Obsessive-Compulsive Disorder

• Obsession- uncontrolled pattern of thoughts– a person suffering from acute anxiety may think

the same thoughts over and over

• Compulsion- repeatedly performing coping behaviors

• A compulsive person may feel compelled to wash his hands 20-30 times a day or avoid stepping on cracks in the sidewalk

• A obsessive person may be unable to rid herself of unpleasant thoughts about death or of a recurring impulse to make obscene remarks in public

• The obsessive-compulsive may wash her hands continually and torment herself with thoughts of obscene behavior

• Obsession- love, hobby that occupies most of your time

• Compulsion- striving to do something perfect

• If a person is deeply engrossed in a hobby or who aims for perfection enjoys this intense absorption and can still function effectively is not considered disabled

• Considered a problem only if such thoughts and activities interfere with what a person wants and needs to do

Why do OCDs develop?

• Serve a diversions from a person’s real fears and origins– Reduce anxiety somewhat

• Compulsions- provide a disturbed person with the evidence that they are doing something well even if they are only avoiding the cracks in the sidewalk

• OCDs do seem to run in families so there may be a possible genetic basis

• Although most people with OCD realize that their thoughts and actions are irrational, they feel unable to stop them

Post-Traumatic Stress Disorder

• A condition in which a person who has experienced a traumatic event feels severe and long lasting aftereffects

• Common among veterans, survivors or acts of terrorism, natural disasters, other catastrophes (plane crashes), and human aggression

• The event that triggers the disorder overwhelms a person’s sense of reality and ability to cope

• Disorder may begin immediately after the occurrence of the traumatic event or its may develop later

Section 3 Somatoform and Dissociative

Disorders

• Dealing with anxiety and stress can lead to somatoform and dissociative disorders

Somatoform Disorders(hysteria)

• Anxiety can create a wide variety of physical symptoms for which no physical cause apparent

• Conversion Disorder• Hypochondriasis

Conversion Disorder• Changing emotional difficulties into a loss

of a specific voluntary body function

• The loss of function is real, but no actual physical damage is present– When someone is so frightened he or she

cannot move

• Results in a real prolonged handicap

La belle indifference

• A man might wake up one morning and find himself paralyzed from the waist down and be calm about it

• Indication that the person is suffering from a psychological problem instead of a physical

• Most psychologists believe that people suffering from a conversion disorder

Hypochondriasis

• A person who is in good health becomes preoccupied with imaginary ailments

• Often misinterprets minor aches, pains, bruises, or bumps as early signs of a fatal illness

Dissociative Disorders

• A disorder in which a person experiences alterations in memory, identity, or consciousness

Dissociative Amnesia• The inability to recall important

personal events or information; is usually associated with stressful events

Dissociative Fugue

• A Dissociative disorder in which a person suddenly and unexpectedly travels away from home or work and is unable to recall the past

Dissociative Identity Disorder

• A person exhibits two or more personality states, each with its own patterns of thinking and behaving

Schizophrenia