Unit 11 Psych: Mental Illness

How are psychological disorders diagnosed?

• Patterns of Behavior → Disorders are marked by repeated irregular thoughts, emotions, or actions.

• Medical Model → Disorders are seen as illnesses of the mind/biology that can be diagnosed and treated.

• The DSM-5 → A manual that contains diagnostic labels and descriptions providing shared concepts of the latest research. Additionally, it’s common language creates a universal diagnosis so that misdiagnosis can be avoided. However some people worry/criticize that the DSM-5 may lead to:

  1. Overdiagnosis → The manual includes a wide range of disorders, which might cause doctors to diagnose normal behaviors as mental illnesses.

     • Example: A child who is very active might be diagnosed with ADHD even if their behavior is just normal childhood energy.

  2. Stigma of Labeling → Being diagnosed with a mental disorder can lead to social judgment or discrimination.

     • Example: Someone diagnosed with schizophrenia might struggle to get a job or be treated unfairly because of negative stereotypes.

     (to sum up: The concern is that while the DSM-5 helps standardize diagnoses, it might also pathologize normal behavior (treating it as a disorder) and attach lasting labels that impact a person’s life.)

• The Four D’s: describes key characteristics that mental health professionals look for when determining if a behavior or condition qualifies as a disorder.

  • Distress – The behavior causes negative feelings such as anxiety, sadness, or pain.

    • Example: A person with depression feels hopeless and struggles to enjoy life.

  • Dysfunction – The behavior interferes with daily life, making it hard to work, study, maintain relationships, or take care of oneself.

    • Example: Someone with severe social anxiety avoids going to school or work.

  • Deviance – The behavior is unusual or goes against societal norms.

    • Example: A person with schizophrenia might have hallucinations that cause them to act in a way others find strange.

  • Danger – The behavior puts the person or others at risk of harm.

    • Example: Someone experiencing severe paranoia may believe others are out to get them and react aggressively.

How have people understood and treated mental illness throughout history?

• Ancient Beliefs → Mental illness was seen as a curse, punishment (from god), or demonic possession.

• Treatment → The mentally ill were often locked in prisons with criminals, were abused and basically no effort was made for treatment.

Who has advanced how psychological disorders have been understood and treated?

• Philippe Pinel → Introduced "moral treatment," believing mental illness/disorders are caused by environmental factors like stress and poverty rather than demons.

• Dorothea Dix → advocated for humane treatment and created the first generation of American mental asylums.

• Nellie Bly → Went undercover in an asylum and exposed the mistreatment of patients in large asylums, leading to reforms. *Was a progressive muckraker (a journalist or writer, who exposes corruption, scandal, or wrongdoing through investigative journalism)

What is the biopsychosocial approach to mental illness?

• Contemporary psychiatry uses the biopsychosocial model (biological, psychological, and social factors) to study disorders:

  • Biological: Genes, brain chemistry, or physical conditions.

  • Psychological: Trauma, stress, or thought patterns.

  • Social: Family, poverty, or cultural expectations.

Overall Example:

• Someone with depression might have a genetic predisposition (biology), struggle with negative thoughts (psychology), and experience social isolation (social factors).

Why has there been a rise in mental illness diagnoses, and how common are mental disorders in the U.S.?

Up to ¼ of the U.S. population suffers from some type of mental illness. This rise in diagnoses has sparked debate—are more people becoming mentally ill due to societal factors, or are we just better at recognizing and diagnosing mental disorders than before?

What are the different types of anxiety disorders, and how do they affect people?

• Generalized Anxiety Disorder (GAD): Persistent, uncontrollable worry. (Example: Someone constantly worries about their job security, even though there is no real threat.)

• Social Anxiety Disorder: Fear of being judged or embarrassed in social situations. (Example: A student avoids speaking in class because they fear saying something wrong.)

• Panic Disorder: Sudden, intense episodes of fear. (Example: A person experiences a racing heart and breathlessness in a crowded mall.)

• OCD (Obsessive-Compulsive Disorder): Uncontrollable, repetitive thoughts (obsessions) and behaviors (compulsions). (Example: Someone washes their hands 20 times a day to prevent imagined germs.)

• PTSD (Post-Traumatic Stress Disorder): Anxiety, nightmares, and withdrawal after trauma. (Example: A soldier avoids loud noises because they trigger war memories.)

• Phobia: Irrational fear of a specific object, activity, or situation. (Example: Someone refuses to enter an elevator due to claustrophobia.)

How does anxiety relate to somatic, and what disorders connect the two?

Anxiety appears to convert itself into a somatic (relating to the body, especially as distinct from the mind) symptom that has no reasonable neurological basis

• Somatic Symptom Disorder: Physical symptoms without a medical cause. (Example: A person experiences chronic pain with no physical explanation.)

• Illness Anxiety Disorder: Interpreting normal sensations as a severe illness. (Example: Someone thinks a mild headache is a brain tumor.)

What perspectives explain anxiety disorders?

• Behavioral Perspective: Conditioning, generalization and reinforcement can reinforce fears. (Example: A child bitten by a dog develops a lifelong fear of dogs.)

• Biological Perspective: Genetic predispositions affect neurotransmitter levels and fear responses. (Example: A person with a family history of anxiety is more likely to develop it.)

What are depressive disorders, and how do they affect emotions?

• Major Depressive Disorder: depressed moods and feelings of worthlessness and or little interest or pleasure in most activities. (Example: A person stops enjoying hobbies and avoids socializing.)

• Persistent Depressive Disorder: long term depressed moods that last for months or even years. (Example: Someone feels down most days for years but still functions.)

• Postpartum Depression: Depression after childbirth—inability to connect with a new baby. (Example: A mother struggles to bond with her baby and feels overwhelmed.)

• Seasonal Affective Disorder (SAD): Depression linked to seasonal changes. (Example: Someone feels depressed every winter but improves in spring.)

• Bipolar Disorder: Extreme mood swings between mania (hyperactive, wildly optimistic, impulsive behavior) and depression. (Example: A person impulsively spends all their money during a manic phase and then isolates themselves when depressed.)

• Disruptive Mood Disorder: Frequent emotional (think anger and irritability) outbursts in children; it may be outgrown. (Example: A child reacts with intense anger over small frustrations.)

What are the dangers of depressive disorders?

• Depression increases the risk of suicide.

  • Suicidal forewarnings include verbal hints, withdrawal, preoccupation with death, and discussing one’s own suicide

• Non-Suicidal Self-Injury (NSSI) can escalate. (Example: Someone cuts themselves as a coping mechanism for emotional pain—not necessary in attempt to kill themselves).)

How do different perspectives explain depression?

• Biological Perspective: Depression is linked to genetic predispositions and abnormalities in brain structures and neurotransmitter function. (Example: A person inherits a tendency for depression from their parents.)

• Social-Cognitive Perspective: stressful experiences, beliefs, attributions, and memories lead to negative moods. (Example: Someone who fails a test believes they will always fail in life.)

What are image disorders, and how do they affect self-perception?

• Anorexia Nervosa: Extreme dieting despite being underweight; most common in adolescent females. (Example: A teen refuses to eat because they think they are “too fat” even at a dangerously low weight.)

• Bulimia Nervosa: Binge-eating then compensating by purging, fasting, or excessively exercising. (Example: A person eats an entire pizza and then forces themselves to vomit.)

• Body Dysmorphia: Obsession with perceived physical flaws or deformities. (Example: Someone believes their nose is “too big” despite reassurance from others.)

How do different perspectives explain image disorders?

• Cognitive Perspective: Internal thoughts overpower the homeostatic drive to maintain a balanced internal state. (Example: A person ignores hunger cues because they believe eating will make them gain weight.)

• Social-Cultural Perspective: Cultural standards contribute to distorted self-image and lead to false narrative of what beauty is. (Example: A model compares herself to photoshopped celebrities and feels inadequate.)

What are impulse control disorders, and how do they lead to deviant behavior?

• Pyromania: An urge to set fires despite a knowledge that fire is dangerous. (Example: A person enjoys watching things burn and starts fires for pleasure.)

• Kleptomania: The compulsion to steal. (Example: Someone steals items they don’t need just for the thrill.)

• Oppositional Defiance Disorder: Extreme defiance against authority. (Example: A child deliberately refuses to follow any rules at home and school.)

How do impulse control disorders relate to addiction?

• People with impulse disorders (ADHD, OCD, and Autism) may develop addictions. (Example: A person with ADHD struggles with impulse control and becomes addicted to gambling.)

• Common addictive disorders include: Substance abuse, gambling, sex, internet, and hoarding.

How do the cognitive and behavioral perspectives explain impulse control and image disorders?

• Cognitive Perspective: Impulse control and image disorders stem from internal thoughts and an inability to delay gratification.
  (Example: A person with an eating disorder constantly thinks about their appearance and cannot resist checking mirrors or dieting excessively.)

• Behavioral Perspective: Repeated behaviors reinforce/condition a lack of self-control.
  (Example: A person addicted to online shopping continues to buy unnecessary items because the temporary excitement conditions them to repeat the behavior.)

How is schizophrenia understood?

• Schizophrenia is a "split mind," meaning a split from reality rather than a split personality.
  (Example: A person may hear voices that aren’t there or believe they have special powers.)

• It affects about 1-2% of the population and is more common in men.

• This condition distorts perception, cognition, and emotion.
  (Example: Someone with schizophrenia may struggle to organize thoughts, misinterpret social cues, or show little emotional expression.)

What are the symptoms of schizophrenia?

• Positive Symptoms (additions to personality):

  • Psychosis: Losing touch with reality (more severe version of delusions) (Example: Believing they are a famous celebrity.)

  • Hallucinations: Seeing/hearing things that aren’t there (Example: Hearing voices telling them what to do.)

  • Delusions: Strong, false beliefs (Example: Thinking they are being poisoned.)

• Negative Symptoms (absence of normal function):

  • Flat affect: Lack of emotional expression (Example: Showing no reaction to happy or sad events.)

  • Apathy: Lack of volition (Example: Not getting out of bed for days.)

What are the different types of schizophrenia?

• Paranoid: Hallucinations, often with negative messages; delusions, both grandiose (A conviction of great talent; believing one has special powers or importance) and persecutory (believing others are out to harm them). (Example: Someone may think they are a famous ruler or that the government is spying on them.)

• Disorganized: incoherent speech and random behavior. (Example: Speaking in random words that don’t make sense together.)

• Catatonic: rarely initiates or controls movements; copies others speech and actions. (Example: Standing frozen in one position for hours.)

• Residual: Only negative symptoms. (Example: Showing no emotion and lacking motivation.)

• Undifferentiated: A mix of different symptoms.

What causes schizophrenia, and what triggers it?

• Chronic vs. Acute Onset/Start:

  • Chronic: disorder develops gradually; recovery is doubtful

  • Acute: Sudden onset after stress, with a better chance of recovery. (Example: A person experiences a mental breakdown after a major life event.)

• Biochemical Causes:

  • Inherited genetically; no known social causes

  • Brain scans reveal abnormal activity in the frontal lobes, thalamus, and amygdala

  • Increased dopamine receptors lead to auditory (Hearing voices or sounds that aren’t actually there) and visual delusions (Seeing things that aren’t real).

What are dissociative disorders, what causes them, and what makes them unique?

• Dissociative disorders involve a disconnect in a person’s thoughts, memories, surroundings, actions, or identity. They usually develop in response to trauma, though there is no evidence that genetics trigger these disorders (although family members likely suffer from other forms of mental illness).

• Dissociative disorders are extremely rare and children who suffer from long term physical, sexual, or emotional abuse have a higher rate of these disorders. Additionally, some people develop dissociative disorders because they grew up in unpredictable and dangerous environments where they never knew when something bad might happen (war, natural disasters, and kidnappings) (leading the brain to dissociate as a coping mechanism).

What are some examples of dissociative disorders?

• Dissociative Amnesia – Inability to recall memories without a physical cause.

  • ex: A soldier who experienced a traumatic battle wakes up one day unable to remember anything about their time in the war, despite having no physical brain injury.

• Dissociative Fugue – no memory of one's life, memory, and identity

  • ex: A man is found in a city with no recollection of who he is or how he got there. He starts a new life under a different name

• Dissociative Identity Disorder (DID) – A person develops separate personalities or "alters."

  • ex: A woman who suffered severe childhood abuse has multiple personalities, including one who is a protective mother figure and another who is a scared child.

• Depersonalization-Derealization Disorder – Feeling detached from one's body or surroundings or unable to control it 

  • ex: A student under extreme stress suddenly feels like they are watching themselves from outside their body, as if they are a character in a movie, and has difficulty feeling real.

What does research suggest about Dissociative Identity Disorder (DID)?

DID is characterized by at least two distinct personality states, called alters, most commonly found in women who suffer from anxiety, depression, or bipolar disorder.
Example: A woman with DID may shift between a reserved, quiet personality and an aggressive, outspoken personality, each with different ways of thinking and behaving.

What are the different psychological perspectives on dissociative disorders?

• Psychodynamic – The id creates different identities as a defense mechanism.

• Cognitive – Dissociation is emotional coping for trauma.

• Behavioral – Dissociation is a learned response to stress (conditioned).

• Social – Some therapists may unintentionally encourage these behaviors.

  • Example: A patient undergoing therapy may start showing DID symptoms after being repeatedly asked if they have "other personalities," reinforcing the behavior.