psych chapter 16 psychological disorders

what are the 3 D’s of abnormality?

• distress: suffering, “feels anxious/sad”

• dysfunction: impairment, “can’t work/socialize”

• deviance: norm violation, “unusual/extreme behaviour”

• a behaviour can be abnormal without all 3 (ex: mania = deviant but not distressing)

why is there no single definition of abnormality?

• depends on:

  • culture

  • personal values

  • social norms

  • statistical rarity (behaviour that is uncommon, rare ≠ abnormal)

what is the DSM-5?

• diagnostic manual with 350+ disorders, using:

  • categorical approach → disorder present or not

  • dimensional approach → severity (mild, severe)

reliability vs validity?

• reliability → consistency across clinicians

  • if 2 psychologists give different diagnoses → low reliability

• validity → whether diagnosis is accurate

  • if someone is diagnosed incorrectly → low validity

what are the consequences of diagnostic labels?

• negative:

  • stigma (societal judgment)

  • bias (interpret behaviour through label)

  • self-fulfilling prophecy

• positive:

  • access to treatment

  • better understanding

  • communication between professionals

what did the Rosenhan Study demonstrate?

• “pseudopatients” reported fake symptoms → admitted

• once labeled schizophrenic, all behaviour interpreted as pathological

• staff couldn’t detect sanity, but other patients often could

• key conclusions:

  • diagnosis lacks validity

  • labels strongly shape perception

  • context matters more than behaviour

Early explanations and treatments of mental illness?

• explanation: supernatural (demons, spirits)

• treatments:

  • trephination (the creation of a hole in the skull to release “evil spirits”)

  • witch hunts (100,000 killed)

what is the vulnerability-stress model?

• disorders occur when:

  • vulnerability (predisposition)

    • genetics

    • personality traits

    • early trauma

• interacts with:

  • stressors

    • life events (loss, exams, trauma)

• both are required

what is the triple vulnerability model?

• biological → genetics, brain sensitivity

• psychological → beliefs, coping skills

• environmental → stress, trauma

• used especially for anxiety + mood disorders

compare the major psychological models

• biological:

  • core idea → brain/genetics

  • scenario clue → family history, neurotransmitters

• psychodynamic:

  • core idea → unconscious conflict

  • scenario clue → childhood trauma

• cognitive:

  • core idea → distorted thinking

  • scenario clue → negative beliefs

• behavioural:

  • core idea → learned behaviours

  • scenario clue → conditioning, avoidance

• sociocultural:

  • core idea → social context

  • scenario clue → culture, gender roles

what are the 4 components of anxiety?

• emotional - fear, dread

• cognitive - worry, threat perception

• physiological - heart rate, sweating

• behavioural - avoidance

• they reinforce each other (ex: thoughts → physical → avoidance)

mechanism of phobias?

• classical conditioning → fear learned

• avoidance → reduces anxiety

• negative reinforcement → strengthens avoidance

GAD vs panic disorder?

• GAD → chronic, ongoing worry (no clear trigger)

• panic disorder → sudden, intense attacks

  • panic attacks are caused by the misinterpretation of bodily senses (ex: increased heart rate → “I’m dying”)

what is the full OCD cycle?

• obsession → intrusive thought

• anxiety increases

• compulsion → reduces anxiety

• relief → reinforces behaviour

biological causes of anxiety disorders?

• genetic predisposition

• overactive amygdala

• low GABA (less inhibition → more anxiety)

cognitive causes of anxiety?

• catastrophizing

• overestimating danger

• underestimating ability to cope

behaviour causes of anxiety?

• classical conditioning (fear learned)

• observational learning (watch others fear)

what maintains anxiety disorders?

• avoidance behaviour:

  • reduces anxiety short-term

  • prevents learning → long-term maintenance

what are culture bound disorders and why are they important?

• disorders specific to cultural contexts

• examples:

  • Koro → fear genitals shrinking

  • Tajin Kyofusho → fear of offending others

  • Windigo → belief of becoming a cannibal

what is anorexia?

• very low weight

• restrictive behaviour

• wants control/perfection

• high mortality risk

what is the full binge-purge cycle?

• stress

• binge (loss of control)

• guilt

• purge

• temporary relief

• person: normal weight, impulsive, risks of physical damage to the body

what maintains eating disorders biologically?

• leptin imbalance → body resists weight gain

• reduced taste sensitivity → easier purging

why are eating disorders more common in Western cultures?

• thin ideal

• objectification

• media influence

what is somatic symptom disorder (SSD)?

• characterized by:

  • extreme anxiety over physical symptoms (pain, fatigue) that are not fully explained by a medical professional

what are dissociative disorders?

• dissociative amnesia:

  • inability to recall important personal info

  • often related to traumatic events that go beyond normal forgetfulness

• dissociative fugue:

  • involves unexpected travel or wandering

  • often with amnesia for one’s identity or past → may lead to assuming a new identity

• dissociative identity disorder (DID):

  • presense of 2 or more distinct identities or personalities that recurrently take control of behaviour, accompanied by memory gaps

what are the symptoms of depression?

• emotional → sadness, hopelessness

• cognitive → negative thoughts, self-blame

• motivation → loss of drive, withdrawal

• somatic → sleep, appetite, fatigue

what is Beck’s cognitive theory?

• negative schemas from early experiences

• leads to cognitive triad:

  • self → “I’m worthless”

  • world → “Everything is bad”

  • future → “Nothing will improve”

• maintained by:

  • biased interpretations

  • ignoring positives

what is learned helplessness in depression?

• repeated negative events → belief no control

• leads to passivity + depression

what is attributional style?

• what really matters is how individuals attribute negative events

• a style of internal, global, and stable causes → depression

what is the behavioural model for mood disorders?

• loss of reward → less activity

• less activity → deeper depression

what are the symptoms of mania in bipolar disorder?

• elevated/irritable mood

• grandiosity (may believe they are better than/superior to others)

• decreased need for sleep

• rapid speech

• impulsively

• severe → risky behaviour

what causes bipolar disorder?

• genetic:

  • identical twins = 4x higher concordance than fraternal

  • biological parents = 3x higher risk than adoptive

  • suggests strong hereditary component

• biochemical factors (Monoamine Theory)

  • imbalance in norepinephrine (NE), serotonin, dopamine

  • depression → decreased NE

  • mania → increased NE

  • mood switch often internal (not triggered by environment)

• psychodynamic:

  • early loss or abandonment

  • anger toward others → turned inward → leads to guilt + self-loathing (depression phase)

when is suicide risk highest?

• not at lowest point (too depressed)

• as energy returns

how should you respond to suicide risk in a scenario?

• always include:

  • ask directly

  • take seriously

  • stay with person

  • get help

what is schizophrenia?

• severe disorder affecting:

  • thought

  • perception

  • emotion

  • behaviour

positive vs negative symptoms?

• positive (added):

  • hallucinations

  • delusions

  • disorganized thinking

• negative (missing):

  • flat affect

  • low motivation

  • reduced speech

• negative = worse prognosis

what are the subtypes of schizophrenia?

• paranoid:

  • most common

  • intense delusions, auditory hallucinations

• disorganized:

  • disorganized speech, behaviour, and thoughts

  • flat or inappropriate emotions

• catatonic:

  • extreme motor abnormalities

  • range from complete lack of movement (stupor) to erratic, rapid, or repetitive movements

• undifferentiated:

  • diagnosed when symptoms are present but don’t clearly fit into one of the other categories

what causes schizophrenia?

• biological predisposition (required)

• genetics:

  • risk increases with genetic similarity

  • DISC1 gene → affects brain development (neural connections)

• biochemical (dopamine hypothesis):

  • excess dopamine → hallucinations + delusions

  • evidence:

    • dopamine-increase drugs (ex: amphetamines, LSD) → psychosis

    • antipsychotics decrease dopamine → reduced symptoms

• neurological:

  • decreased cortical tissue (brain loss) → impaired thinking + processing

• environmental stress (triggers onset):

  • trauma, life stress

  • low socioeconomic status

  • family conflict

what is expressed emotion (EE)?

• family environment has:

  • criticism

  • hostility

  • overinvolvement

• high EE → relapse after release

what is antisocial personality disorder (ASPD) and its causes?

• lack of guilt, remorse, or empathy

• manipulative and deceitful

• impulsive and irresponsible

• often charming but harmful

• behavioural patterns:

  • criminal behavioural

  • aggression and violence

  • chronic irresponsibility

• biological causes:

  • genetic predisposition

  • low arousal (low resting heart rate) → seeks stimulation

  • brain abnormalities:

    • prefrontal cortex → poor decision-making/impulse control

    • amygdala → reduced fear/empathy

• psychological causes:

  • weak superego (Freud) → poor moral development

  • poor impulse control

• learning factors:

  • poor fear conditioning (not afraid of consequences)

  • modelled aggression

  • deviant peer groups

what is BPD?

• emotional instability → intense, rapidly changing moods

• identity disturbance → unstable sense of self

• unstable relationships → extreme highs/lows

• behaviour patterns:

  • impulsively

  • self-harm + suicide attempts

  • fear of abandonment

• splitting → seeing people as all good or all bad (no middle ground)

• causes (biopsychosocial):

  • childhood trauma/abuse

  • unstable or inconsistent parenting

  • genetic + brain factors (emotional regulation issues)

what is ADHD?

• inattention

• hyperactivity

• impulsively

• most common childhood disorder and more common in boys

• functional impact:

  • academic difficulties

  • social problems

  • trouble following rules or instructions

• biological causes:

  • strong genetic component

  • brain differences in prefrontal cortex → impaired attention, planning, impulse control

• environmental:

  • parenting style (ex: inconsistent structure) can influence severity, not cause

what is autism spectrum disorder?

• social interaction deficits (difficulty understanding social cues, limited relationships)

• communication impairments (delayed speech, difficulty with conversation)

• repetitive behaviours (rigid patterns, restricted interests)

• behaviours:

  • avoids eye contact

  • echolalia → repeats words/phrases

  • strong need for routine → distress with change

  • may show savant skills (exceptional abilities in specific areas, commonly music)

• theory of mind impairment → difficulty understanding others’ thoughts, feelings, intentions

• biological causes:

  • brain abnormalities affecting development and connectivity