(0) 🧠 CHAPTER 14 — THE TROUBLED MIND

What is abnormal psychology?

The scientific study of psychological disorders — including their causes, symptoms, and treatments. It examines what constitutes "abnormal" behavior, how it differs from the norm, and how it can be addressed therapeutically.

What is comorbidity?

The co-occurrence of two or more psychological disorders within the same individual, which can complicate diagnosis and treatment.

What is the DSM-5?

The Diagnostic and Statistical Manual of Mental Disorders (5th edition) — the primary classification system used by clinicians to diagnose mental disorders. It lists diagnostic criteria and symptom patterns but does not explain causes or prescribe treatment.

What are some limitations of the DSM-5? ( Diagnostic and Statistical Manual of Mental Disorders (5th edition))

Reflects cultural bias (definitions of "abnormal" vary across societies).
Overlaps among disorders can make diagnosis complex.
Provides a starting point, not a full understanding of the individual.

What perspectives are integrated to understand psychological disorders?

Biological: Brain structure, neurotransmitters, genetics.
Cognitive: Thought processes and perception.
Developmental: Early experiences and critical periods.
Social/Personality: Relationships, personality traits, social environment.
Clinical: Patterns of behavior and treatment response.

Why are multi-factorial or inclusive models important in understanding disorders?

Because psychological disorders often emerge from complex interactions among biological vulnerabilities, environmental influences, and cognitive-emotional processes. Inclusive models enable more individualized and effective treatments.

Define Autism Spectrum Disorder (ASD).

A neurodevelopmental disorder characterized by deficits in social communication and interaction, along with repetitive or ritualistic behaviors. Severity ranges from mild to profound impairment.

What are hallmark symptoms of ASD?

Lack of eye contact and social reciprocity.
Difficulty understanding others' perspectives (theory of mind deficits).
Resistance to changes in environment or routine.
Repetitive behaviors or intense focus on specific interests.
Sometimes superior auditory processing (e.g., perfect pitch).

What is the prevalence and gender ratio of ASD?

Occurs in ~1 out of 54 children; boys are diagnosed 4.3 times more frequently than girls.

What biological findings are linked to ASD?

Narrow minicolumns in the cerebral cortex with normal cell count but spaced farther apart.

Structural abnormalities in amygdala, hippocampus, and cerebellum.

Possible genetic vulnerabilities (no single gene identified).

What environmental factors may increase ASD risk?

Advanced parental age.

Prenatal exposure to infection, toxins, pesticides, nutritional deficiencies, or certain medications (e.g., antidepressants).

No link between vaccines and autism has been found.

What defines ADHD?

A disorder marked by inattention, hyperactivity, and/or impulsivity, to a degree that impairs functioning.

What are common symptoms of ADHD?

Inability to sustain attention or follow instructions.

Difficulty with organization and completing tasks.

Fidgeting, impulsive decision-making, and excessive talking.

Problems with structured or monotonous activities.

How common is ADHD?

Using DSM criteria, between 3-5% of children should qualify for diagnosis, though overdiagnosis occurs with relaxed criteria.

What biological and environmental causes are linked to ADHD?

Heritability: About 70% or more.

Brain differences: Smaller amygdala, basal ganglia, and hippocampus; abnormal dopamine activity.

Environmental: Lead exposure, prenatal tobacco/alcohol/drug exposure, and low birth weight.

Not caused by sugar or poor parenting.

What is schizophrenia?

A severe mental disorder characterized by distortions in thought, perception, emotion, and behavior, often including hallucinations and delusions.

What are the primary positive symptoms of schizophrenia?

Delusions: False beliefs (e.g., paranoia, grandiosity, control).

Hallucinations: Sensory experiences without external stimuli, especially auditory ("hearing voices").

Disorganized speech and behavior.

What are negative symptoms of schizophrenia?

Restricted affect (flat emotion).

Avolition (lack of motivation).

Asociality (social withdrawal).

What biological factors contribute to schizophrenia?

Strong genetic predisposition.

Enlarged ventricles and reduced frontal lobe activity.

Abnormal brain development during adolescence.

Dopamine dysregulation.

Possible genetic marker: abnormal eye movement tracking.

What environmental factors increase schizophrenia risk?

Chronic stress and low socioeconomic status (5× higher risk).

Social isolation due to minority status.

Prenatal exposure to viruses.

Cannabis use, especially high-potency or daily use, which may triple or quintuple risk.

What is bipolar disorder?

A mood disorder characterized by alternating episodes of mania (elevated mood, energy) and depression. It serves as a bridge between psychotic disorders and depressive disorders.

What are symptoms of a manic episode?

Inflated self-esteem or grandiosity.

Decreased need for sleep.

Rapid speech and flight of ideas.

Increased goal-directed activity.

Impulsivity and poor judgment.

What is the prevalence and typical onset of bipolar disorder?

Affects ~2.6% of U.S. adults; average onset ≈ 25 years; women diagnosed slightly more often (3:2 ratio).

What biological and environmental factors are associated with bipolar disorder?

Genetic predisposition and oxidative stress (linked to cellular aging).

Possible neuroprotective effect of omega-3 fatty acids.

Overrepresentation in creative and artistic populations.

What is Major Depressive Disorder?

A mood disorder involving persistent depressed mood or loss of interest/pleasure (anhedonia), along with multiple emotional, cognitive, and physical symptoms lasting at least two weeks.

What are the main symptoms of MDD?

Core: Depressed mood or anhedonia.

Physical: Sleep/appetite disturbance, fatigue, psychomotor agitation.

Cognitive: Poor concentration, guilt, hopelessness, suicidal thoughts.

What is the prevalence of MDD?

About 7% of adults, most common among ages 18-29 (three times more than 60+). Women are affected more frequently than men.

What theories explain MDD?

Learned helplessness: Perception of no control → depression.

Cognitive model: Negative triad (self, world, future); rumination maintains depression.

Social: Loneliness and isolation increase risk.

Biological: ~35% heritability, 80+ genes identified.

Serotonin dysregulation affects mood, sleep, and appetite.

Circadian rhythm disturbance (too much REM sleep).

Diathesis-stress model: Stress interacts with biological predisposition.

What are the two key components of anxiety?

Strong negative emotion (fear, dread).

Physical tension in anticipation of danger.

What defines an anxiety disorder?

An exaggerated, maladaptive version of a normal protective response, often chronic and disruptive.

What is the relationship between anxiety and MDD?

They frequently co-occur (comorbid), often sharing genetic and neurobiological risk factors.

What are phobias?

Irrational, intense fears of specific objects or situations (e.g., animals, heights, injury). They may develop through classical conditioning or cognitive distortions.

What is panic disorder?

Recurrent panic attacks (sudden, intense fear with physical arousal) and fear of future attacks.
Causes: Genetic predisposition (orexin system), social stress, misinterpretation of physical symptoms, and cultural influence.

What is generalized anxiety disorder (GAD)?

Persistent, excessive worry not tied to specific situations; individuals often have high-reactive temperaments, maladaptive thinking patterns, and elevated life stress.

Define Obsessive-Compulsive Disorder (OCD).

Disorder involving intrusive thoughts (obsessions) and repetitive, anxiety-reducing behaviors (compulsions) like handwashing, counting, or checking.

What are Social Anxiety Disorder, Agoraphobia, and Body Dysmorphic Disorder?

Social Anxiety: Fear of judgment or embarrassment.

Agoraphobia: Fear of open or public spaces.

Body Dysmorphic Disorder: Obsessive focus on perceived physical flaws.

What causes PTSD according to DSM-5?

Exposure to trauma — it's the only disorder with a specified cause.

What are key symptoms of PTSD?

Flashbacks, intrusive memories, nightmares.

Hypervigilance and emotional numbness.

Avoidance of trauma-related stimuli.

What are historical terms for PTSD?

Shell shock (WWI) and battle fatigue (WWII).

What are dissociative disorders?

Disorders involving disruptions in identity, memory, or consciousness — often triggered by trauma.

What are the main types of dissociative disorders?

Dissociative Amnesia: Memory loss for traumatic events.

Dissociative Fugue: Amnesia + identity confusion/new identity.

Depersonalization/Derealization: Feeling detached from self/reality.

Dissociative Identity Disorder (DID): Two or more distinct personalities.

What is Somatic Symptom Disorder?

Physical symptoms without medical cause that cause distress and frequent medical visits; may lead to dependence on pain medication.

What defines a personality disorder?

Enduring, inflexible patterns causing impairments in identity, empathy, and interpersonal functioning.

What characterizes Antisocial Personality Disorder?

Persistent disregard for others' rights and societal rules.

Manipulative, impulsive, lacking remorse.

Causes: Genetic predisposition + childhood abuse; reduced prefrontal cortex activity.

What characterizes Borderline Personality Disorder?

Instability in relationships, mood, and self-image.
Intense fear of abandonment; self-destructive behavior.
70% have histories of abuse or neglect.
Often comorbid with bipolar, substance, or eating disorders.

What defines Narcissistic Personality Disorder (NPD)?

Grandiosity, excessive need for admiration, and lack of empathy.

Grandiose type: Dominant, aggressive, inflated self-worth.

Vulnerable type: Insecure, defensive, emotionally reactive.

Research shows links between social media use and narcissism; younger people show higher rates.

What model best explains the interaction between genetics and environment in psychological disorders?

The Diathesis-Stress Model — predispositions interact with environmental stressors to trigger disorders.

How do culture and society influence psychological disorders?

Culture affects definitions of abnormality, symptom expression, stigma, and access to treatment.

Why is an integrated perspective crucial in modern psychology?

Because disorders are rarely caused by one factor — combining biological, cognitive, social, and developmental lenses leads to better diagnosis and treatment.