CHP 15 - PSYCHOLOGICAL DISORDERS

What’s Abnormal Psychology? 

• talks about specific disorders 

• understand how we determine a certain behaviour is abnormal 

How Does One Determine “Abnormal”?

• diagnostician making the judgement

• expectations of social norms/cultural origin

• judgements about right or wrong

• stat. deviation from the norm

• determining based on harmfulness

3 D’s of Abnormal Behaviour

• deviant 

• dysfunctional (maladaptive)

• distressing 

3 D’s of Abnormal Behaviour - Deviant

• does the behaviour violate social norms

3 D’s of Abnormal Behaviour - Dysfunctional

• does the behaviour impair a person’s everyday behaviour 

• maladaptive for person or society 

3 D’s of Abnormal Behaviour - Distressing

• does the behaviour cause the person distress in themselves and/or others 

Define Diagnosis

• identifying an illness or disorder 

Define Etiology

• refers to the apparent causation and developmental history of an illness

Define Prognosis

• forecast of a probable course of an illness

• how the illness progresses 

Define Prevelence

• proportion of a population with a disorder at a given time 

• ex. current, specific time span, lifetime 

Example of Lifetime Prevalence Discussed in Lecture

• would be the percentage of people that have been diagnosed with a certain disorder at any time in their life 

• ex. 44% of adult population will have some sort of psychological disorder at a point in their life 

Historical Perspectives - Demonic Model

• that abnormal behaviour came from supernatural forces

• trephination practice → make hole in skull = evil spirit leaves 

Historical Perspectives - Medical Model

• abnormal behaviour is the result of bodily processes

• that disorders are dieases 

Early Biological Views

• that mental illnesses are diseases that affected the brain 

• breakthrough that disorders were linked to physical causes 

  • ex. general paresis (brain disease) caused by syphilis 

What was Bloodletting (1700s)? 

• drained blood from patients to cure them 

• some got better → assumed bc of the treatment 

• some died → didn’t matter since they “would’ve died anyways” 

Why Are Comparison Groups Important in Regards to Bloodletting?

• didn’t systematically count the death rates among patients to a comparison group of those who didn’t get a treatment or had a different treatment 

What’s Institutionalization?

• movement to relocate mentally ill indvs. into asylums or institutions 

• removed them from community 

  • problematic

What’s Deinstitutionalization?

• movement to remove mentally ill individuals from institutions and instead integrate them into communities 

What’s the Vulnerability Stress Model (Diathesis Stress Model)?

• that the development of disorders is influenced by the complex interaction between genes and environ

• that disorders can be developed because of vulnerability factors

Elaborate on the Diathesis Stress Model 

• genes provide an underlying vulnerability to a given disorder

• environmental stressors influence the likelihood of developing that disease 

• ex. biological traits + current stressors like trauma 

Diagnostic Considerations - Reliability

• that clinicians using the system should show high levels of agreement in their diagnostic decisions 

• diagnosing the same person and using the same tools = other people should reach similar conclusions 

Diagnostic Considerations - Validity

• the diagnostic categories should accurately capture the essential features of various disorders 

• disorder is clearly described, then the diagnostic categories should capture those features 

DSM 5 - Section 1

• history of revisions and changes 

DSM 5 - Section 2

• criteria for main diagnostic categories and other disorders 

• lists disorders and their symptoms 

DSM 5 - Section 3

• assessment measures 

• criteria for disorders that need further research 

• includes 22 major categories of disorders 

Criticism With the DSM 5 - Concerns with Validity

• describing symptoms, not the disorder

• disorders can have different symptoms 

Criticism With the DSM 5 - High Comorbidity

• people are likely to have multiple diagnostic labels that can overlap 

• so one disorder usually comes with another 

Alternatives to DSM 5 - ICD 10

• international classification of disease and health related problems 

• commonly used in Europe 

Alternatives to DSM 5 - RDoC

• research domain criteria project 

• sometimes used in the U.S 

Issues with Diagnostic Labels - Social and Personal Considerations

• becomes easy to accept a label as a description of the indv. 

• assume indv. fits stereotype of the disorder 

• indv. may accept their new identity implied by the label 

Issues with Diagnostic Labels - Legal Consequences

• involuntary commitment from some part of the patient

• loss of civil rights 

• indefinite detainment 

Issues with Diagnostic Labels - Legal Considerations

• competency → state of mind at time of judicial hearing 

• insanity → state of mind at time the crime was committed 

What’s Culture Universality?

• many disorders are found across multiple cultures with similar symptoms 

• names and treatments may differ 

What’s Culture Bound Disorders?

• disorders only found in certain cultures or specific contexts 

What are Anxiety Disorders? 

• marked by feelings of excessive apprehension 

• feeling gets out of your hands 

• frequency and intensity are out of proportion to situations that trigger them 

What are the 4 Responses to Anxiety Disorder Responses?

• emotional 

• cognitive 

• physiological 

• behavioural 

Anxiety Disorder Responses - Emotional

• feelings of tensions 

Anxiety Disorder Responses - Cognitive

• worry and thoughts about inability to cope

Anxiety Disorder Responses - Physiological

• increased heart rate, muscle tensions, other arousal symptoms

• ex. not being aware

Anxiety Disorder Responses - Behavioural

• avoidance of feared situations

• decreased tasks performance

• increased startle response 

What’s General Anxiety Disorder (GAD)?

• chronic, high levels of diffuse anxiety that aren’t tied to any specific threat

• constant feeling that something bad is gonna happen 

• constant activation of the fight or flight response 

Elaborate More On GAD

• starts at an early age than other anxiety disorders

• development of GAD probably came from something traumatic 

• less found in certain ethnicities 

• common in women than men 

What’s Phobic Disorder (Phobias)?

• intense, persistent, and irrational fears of objects or situations that pose no real threat 

• degree of impairment depends on how often you encounter the situation 

• reactions can’t be prevented

Elaborate More On Phobic Disorder

• developed in childhood or adolescence

• can get worse without treatment over time 

• require therapy like exposure therapy 

• more common in women than in men

Phobic Disorder - Agoraphobia

• fear of open spaces or public spaces

Phobic Disorders - Social Phobias 

• fear of situations that involve being around other people 

Phobic Disorder - Specific Phobias

• relate to fear of specific objects like animals or situations

What’s Panic Disorder?

• recurrent, intense instances of anxiety with sudden and unexpected onset 

• can develop in early childhood or late adolescence 

• more common in women than men

What’s a Panic Attack? 

• unexpected anxious feelings that can ramp up in intensity to fear or terror 

• may worry about the possibility of having more panic attacks in the future

What’s an Anxiety Attack?

• often triggered by a specific stressor present 

Elaborate on the relationship between panic attacks and separation from parents

• happens during childhood 

• could do something with the kids’ attachment style

• could be a third variable involved 

Factors Involved in Anxiety Disorders - Biological Factors

• genetics involved in developing these disorders 

• neurotransmitter present in brain that can be measured that affects whether these anxiety disorders happen or not 

Factors Involved in Anxiety Disorders - Cognitive Factors

• maladaptive thoughts and beliefs

• things appraised “catastrophically” 

Factors Involved in Anxiety Disorders - Environ. Learning Factors

• disorders could be learned 

• classical conditioning → associate an object/situation with pain and trauma 

• social learning → learn by watching others

  • ex. watching someone suffer with anxiety that you learn to have a response to a similar stressor 

Factors Involved in Anxiety Disorders - Sociocultural Factors

• culture defines what’s important 

• will influence what people worry about 

• ex. greater fear of offending someone in a certain culture 

Sex Differences in Anxiety Disorders

• women tend to exhibit more anxiety disorder than men 

Sex Differences in Anxiety Disorders - Biological Disposition

• that there’s a chromosome that provides a biological disposition that develops a anxiety disorder 

Sex Differences in Anxiety Disorders - How Women Were Raised

• taught that they don’t have as much power or control compared to boys 

Sex Differences in Anxiety Disorders - Cultural Norms

• norms for expression of emotions 

• men taught that it’s not socially acceptable to express feelings or emotions 

Sex Differences in Anxiety Disorders - Data Coming From Clinic Records

• women are more likely to seek help when they feel like they need to compared to men 

What’s Obsessive Compulsive Disorder (OCD)?

• persistent, uncontrollable instructions of unwanted thoughts and urges to engage in ritual behaviours 

• prevalence equal between sexes

• can include a number of sub-disorders  

OCD - Obessions

• cognitive component

• repetitive and unwelcoming thoughts

OCD - Compulsions

• behavioural component 

• repetitive behavioural responses that are performed as a result of these obsessions 

• reacted because it reduces the anxiety to comply 

  • higher likelihood of complying in the future so you keep acting on those behaviours 

What’s Post Traumatic Stress Disorder (PTSD)? 

• enduring psychological disturbance after experiencing traumatic events 

• includes physical and emotional trauma

• can come from direct or indirect experiences with short or long term exposure

Elaborate More on PTSD

• could include insomnia, flashbacks, or anxiety as symptoms 

• indvs. may be more susceptible to PTSD than others

• could do with biology or past upbringings 

What’s Depression (Mood Disorder)?

• involves deeper symptoms than js feeling sad 

• increase of this disorder esp in young people

Depression - Clinical Depression

• symptoms happen too frequently, they’re intense, and they last long (duration) 

• out of proportion 

• ex. being sad for 5 months over a small thing 

Depression - Major Depressive Disorder

• persistent feelings of sadness, despair, and loss of interest in activities that used to bring enjoyment 

• anhedonia → reduced ability to experience pleasure 

• may last for weeks, months, or years 

Depression - Chronic Depressive Disorder

• far less intense → mild or moderate

• but can be long lasting 

Emotional Symptoms of Depression

• sadness, hopelessness, anxiety, misery, inability to enjoy 

Cognitive Symptoms of Depression

• negative recognitions about self, world and future 

• needs patients to self report their feelings 

Motivational Symptoms of Depression

• loss of interest, lack of drive, difficulty 

What’s the Prognosis With Depression

• 50% of people → depression will recur 

• 40% of people → depression will never recur after recovery

• 10% → never recur; chronic depression

What’s Bipolar 1 Disorder?

• includes periods of depression alternate with mania

• manic state symptoms will be opposite compared to depressive state 

• single manic episode is sufficient for diagnosis 

What’s Bipolar 2 Disorder?

• periods of depression alternate with hypomania 

• hypomania is shorter and less severe 

• mania and depression is mild

Bipolar 1 Characteristics - Emotional

• manic → euphoria, high, elated 

• depressive → gloomy, hopeless, socially withdrawn, irritable 

Bipolar 1 Characteristics - Cognitive

• manic → racing thoughts, need for action, impulsive, talkative 

• depressive → slow thinking, obsessive worrying, negative self image 

Bipolar 1 Characteristics - Motor

• manic → hyperactive, tireless, less sleep, increased sex drive, changes in appetite 

• depressive → less active 

What’s Seasonal Affective Disorder (SAD)?

• pattern of depression that rises and falls with the seasons 

• circannual rhythm → rhythm aligned with changes of the seasons

• happens a lot for people who alr suffered depression 

Elaborate More On SAD

• excessive sleep and increased appetite 

• shorter days and reduced daylight important in winter depression 

• stress (no sunlight) triggers reactions to this disorder 

• more depressed in the summer than in winter 

Factors Involved in Mood Disorders - Biological Factors

• under-activity of norepinephrine, dopamine, serotonin for depression

• for mania, overactivity 

• bipolar has a stronger biological component 

Factors Involved in Mood Disorders - Psychological Factors: Personality Based Vulnerability  

• certain personality types can be more vulnerable to these disorders

• esp personalities that have negative thought patterns + negative self-perceptions

Factors Involved in Mood Disorders - Psychological Factors: Psychodynamic View

• early traumatic losses/rejections create vulnerability 

Factors Involved in Mood Disorders - Psychological Factors: Humanistic View 

• define self worth in terms of indv. attainment 

• that indvs. will react more strongly to failures due to inadequacies 

• experience of meaninglessness if there’s failure 

Factors Involved in Mood Disorders - Cognitive Factors

• depressive cognitive triad → negative thoughts concerning the world, oneself, and the future

• can’t suppress negative thoughts

• recall more failures than successes

• attribute success to factors outside yourself; attribute negative factors to you

Factors Involved in Mood Disorders - Environ. Social Learning

• learned helplessness

• looking for help and whatever you’ve done isn’t helping

• learn that your disorder is helpless and you can’t do anything about it

Factors Involved in Mood Disorders - Sociocultural Factors

• prevalence of depressive disorders

• feelings of guilt an inadequacy

What’s Depersonalization Disorder? 

• feeling separated from your body 

What’s Derealization Disorder?

• sense that the world is strange or unreal

What’s Dissociative Amnesia?

• forgetting that’s not explained by normal memory loss 

• can follow trauma 

What’s Dissociative Figure?

• characterized by sudden and unexpected travel and loss of identity 

• inability to recall past 

• temporary state of memory loss that can last 4 hours to a month

• stress mechanism 

What’s Dissociative Identity Disorder (DID)?

• presence of 2+ personality states within and indv. 

• each identity/alter is unique 

  • own set of memories, ideas, thoughts 

• difficult to falsify

What are Causes of DID?

• Theory of the Post-traumatic Model

• that DID results from severe traumatic experience during early childhood 

• identities could be there to play a role with managing the traum

Elaborate on Personality Disorders

• exhibit stable and flexible and maladaptive ways of thinking, feeling, and behaving

• 10-15% of adults in Canada, States, and Europe will have personality disorders

What’s Anti Social Personality Disorder?

• exhibit little anxiety, shows no regret for right and wrong 

• no conscience 

• fail to think about long term negative consequences of their actions

Why is is Anti Social Personality Disorder thought to be most destructive to society? 

• thought to be most destructive to society bc of the behaviour 

• tend to be impulsive and often manipulative

• delay gratification of needs → act on needs ASAP

What are Biological Explanations for Anti Social Personality Disorder?

• genetic predisposition 

• brain imaging techniques shown differences in brain areas 

What are Learning Explanations for Anti Social Personality Disorder?

• social learning about aggression since you can get this at a young age

• exposed to deviant peers

• parents ignore your needs 

What’s Narcissistic Personality Disorder?

• lack empathy for others 

• oversensitivity to evaluation and criticism 

• constant need for admiration from others 

What’s Borderline Personality Disorder?

• instability in behaviour, emotion, and identity

• characterized by impulsive behaviour (ex. running away) 

• emotional dysregulation (can’t control negative emotions) 

• view the world as more dangerous 

• chaotic personal histories