Ch. 15 Psychological Disorders

Psychological disorder

difficult to define, complex and diverse, what is considered abnormal isn’t stable and varies across time and culture, family-resemblance view

Family-resemblance view

members of a category share some features, not necessarily all features

Some criteria for psychological disorders

statistical rarity, subjective distress, impairment, societal disapproval, biological dysfunction 

Statistical rarity 

are uncommon in the population 

Subjective distress

cause the person distress

Impairment

interfere with daily functioning

Societal disapproval

socially unacceptable

Biological dysfunction

involves brain impairments

Defining and diagnosing people

DSM-5

DSM-5 

diagnostic and statistical manual of mental disorders

manual outlining a standard system for labeling and diagnosing mental disorders

biopsychosocial approach

Biopsychosocial approach

recognizes the interplay of biological, psychological and social factors

they all determine/support mental health 

Classifying individuals  

can be harmful, we do not classify individuals by their diagnosis aka say person with schizophrenia not a schizophrenic 

Comorbidity

co-occurrence of 2 or more diagnoses like panic disorder and agoraphobia

Cultural variations

what we consider a mental disorder is culturally determined (homosexuality)

some mental disorders are culture specific (anorexia, koro, taijin kyofusho)

rates of disorders vary across cultures (ADHD)

Anxiety disorders

disorders in which the most common symptom is fear or anxiety 

29% of people will meet the criteria for an anxiety disorder at some point in their lives 

Panic disorder

panic and panic attack

characteristics: anxiety related to having panic attacks

diagnosis: experienced at least 2 panic attacks, each followed by at least 1 month of anxiety over the occurrence of another attack, 2-5% of US population meet criteria, 20-25% of college students report at least 1 panic attack 

Panic

feelings of helpless terror

Panic attack

brief intense episodes of extreme fear and feelings of impending death or insanity

may feel heart racing, shortness of breath, dizziness

no specific trigger: can occur at any time without warning

Generalized Anxiety Disorder (GAD)

characteristics: constant and undifferentiated worry, worry about common things but much much more, muscle tension, difficulty sleeping

diagnosis: at least 6 months of self-disrupting worry that’s independent of any other disorder, 3-6% of US population meet criteria

Phobias

specific, irrational fears

specific phobia 

agoraphobia 

social anxiety disorder 

diagnosis: fear must be long-standing and disrupt normal functioning, 7-13% of US population meet criteria

Specific phobia

arachnophobia, acrophobia, claustrophobia, gynophobia, anthophobia, arachibutyrophobia 

Agoraphobia

fear of the marketplace, fear situations where escape may be difficult or help may not be available if needed

Social anxiety disorder

excessive fear of social situations: being closely watched, judged, and criticized by others 

Obsessive-Compulsive Disorder aka OCD

classified as an obsessive-compulsive and related disorder: class of disorders characterized by repetitive thoughts and behaviors 

repeated and lengthy immersion in obsessions and/or compulsions

diagnosis: obsession and/or compulsions must consume at least one hour each day and seriously interfere with daily functioning, 1-2% of US population meet criteria 

Obsessions

persistent ideas thoughts or impulses that are unwanted, inappropriate and usually cause distress, all-consuming 

Compulsions

repetitive behaviors or mental acts to reduce or prevent distress

Post-traumatic Stress Disorder aka PTSD

PTSD is a trauma and stressor-related disorders: class of disorders involving linked exposure to a traumatic or stressful event 

characteristics: marked emotional disturbance after extremely traumatic event, common in soldiers, flashbacks and/or nightmares, loss of sleep, startling easily 

diagnosis: prevalent distress stemming from dangerous or life-threatening event, up to 7% of the US population may meet criteria but rates vary with culture and world events

Mood disorders

disorders which involve a disturbance in mood or emotions (too high or too low)

20% of people will meet the criteria for a mood disorder at some point in their lives

major depressive disorder

bipolar disorder

Major depressive disorder

characteristics: prolonged sadness and self-blame, feelings of worthlessness, absence of pleasure, changes in sleep or eating habits, suicidal thoughts 

diagnosis: very severe symptoms that last at least 2 weeks, up to 16% of US population meet criteria

persistent depressive disorder: aka dysthymia in DSM-4, mild depressive symptoms for at least 2 years 

causes and perpetuation: interpersonal model (put negative feelings onto others), behavioral model (don’t go out and do usual things), cognitive model (less focus on positive, hyper focus on negative)

Bipolar Disorder

Characteristics: presence of both depressive and manic episodes in alternation

Diagnosis: depression and at least one manic episode 3-4% of US population meet criteria

Bipolar I

Bipolar II

Cyclothymia

Manic episode

dramatically elevated mood, heighten self-esteem, decreased need for sleep, hyperactivity, reckless decisions

Bipolar I

manic episodes and major depression

Bipolar II

hypomania (mild mania) and major depression

Cyclothymia

mild form of bipolar disorder, characterized by persistent depressive disorder aka mild depression and at least one episode of mild mania

Dissociative Identity Disorder aka Multiple Personality Disorder

dissociative disorder which is class of disorders involving a disconnect in thoughts, memory, identity, etc.

Characteristics: presence of two or more distinct identities called alters that recurrently take control of one person’s body

not well understood and highly controversial

explanations: posttraumatic model and sociocognitive model

Alters

can be different ages, gender, races

usually distinct personalities and/or abilities that differ from the “host” personality including handwriting, eyeglass prescriptions, etc.

Posttraumatic model

coping mechanism - severe child abuse results in compartmentalizing of the self

other alters arise to cope with situations when the host is overwhelmed

Sociocognitive model

alters are mainly created in therapy through suggestion, hypnosis and coaxing

ex: diagnosis of DID tends to follow media attention

Schizophrenia

psychotic disorder which is a class of disorders involving disruptions in thoughts, perceptions, emotions, etc.

Characteristics: severe disorder of thought and emotion, associated with a break from reality and severe impairment in daily functioning and relationships and symptoms are highly variable

diagnosis: severe impairment of everyday functioning plus at least 2/5 of the following: delusions, hallucinations, disorganized thought and speech, disorganized behavior, negative symptoms

Delusions

strongly held beliefs with no basis in reality

ex: delusion of persecution, delusions of being controlled, delusion of grandeur

Hallucinations

sensory perceptions that occur in the absence of external stimuli: seeing imaginary people and hearing voices (thought to be a confusion of the person’s inner monologue)

Disorganized thought and speech

incoherent speech

may arise from meaning, word association difficulties

Disorganized behavior

strange or inappropriate behavior

catatonia

echolalia

Catatonia

motor problems

Echolalia

repeating phrases like a parrot

Negative symptoms

lack or reduction in normal thoughts, emotions, drives or behavior