Psychological Disorders

Psychological Disorders

14.1 General Concepts

• Misconceptions about abnormal behaviour are common.

• This section discusses:

  • The medical model of abnormal behaviour.

  • The criteria of abnormal behavior.

  • The classification of psychological disorders.

Key Learning Goals

• Evaluate the medical model of psychological disorders.

• Identify the key criteria of abnormality.

• Describe recent developments and issues related to the DSM-5 diagnostic system.

14.1.1 The Medical Model Applied to Abnormal Behavior

• The medical model proposes that abnormal behavior is useful to think of as a disease.

• This view is the basis for terms like "mental illness" and "psychological disorder."

• Medical model represented progress over earlier models based on superstition.

• Before the 18th century, abnormal behavior was attributed to demons, witchcraft, or divine punishment.

• The medical model led to more humane treatment, viewing those affected with sympathy rather than hatred or fear.

• Critics argue the medical model may have outlived its usefulness.

• Medical diagnoses can place stigmatizing labels on people (e.g., "psychotic," "schizophrenic").

• This can lead to prejudice, social distancing, and rejection.

• Stigma prevents people from seeking needed mental health care.

• Research showing genetic and biological factors in psychological disorders hasn't reduced stigma.

• Biogenetic explanations can increase the view that disorders are untreatable and affected individuals are unpredictable/dangerous.

• Thomas Szasz argues that only the body can be diseased, not the mind.

• He believes abnormal behavior is deviation from social norms, a "problem in living" rather than a medical issue.

• Szasz argues the medical model turns moral and social questions into medical ones.

• Despite criticisms, the medical model remains dominant in thinking about psychological disorders.

14.1.2 Criteria of Abnormal Behavior

• Complex questions arise when judging normality vs. abnormality (e.g., a neighbor who excessively cleans).

• Formal diagnoses made by mental health professionals rely on criteria including:

  1. Deviance:

     • Behavior deviates from what society considers acceptable.

     • Normality varies across cultures.

     • Violating standards can lead to being labeled mentally ill.

     • Example: Transvestic fetishism is considered a disorder because cross-dressing deviates from cultural norms for men.

     • Cultural standards evolve; cross-sex dressing has become more accepted with time.

  2. Maladaptive Behavior:

     • Everyday adaptive behavior is impaired.

     • Key criterion for substance use disorders.

     • Cocaine use interfering with social/occupational functioning indicates a disorder.

     • Compulsions like repetitive cleaning are also maladaptive.

  3. Personal Distress:

     • Individual reports great personal distress.

     • Commonly met by people troubled by depression or anxiety.

     • Depressed people may or may not show deviant/maladaptive behavior, but are labeled disordered when they express personal pain.

• Diagnoses involve value judgments about what is normal/abnormal, reflecting cultural values, social trends, political forces, and scientific knowledge.

• Normality and abnormality exist on a spectrum; it's a matter of degree.

14.1.3 Psychodiagnosis: The Classification of Disorders

• Classifying mental disorders aids research and communication among scientists and clinicians.

• The American Psychiatric Association publishes the Diagnostic and Statistical Manual of Mental Disorders (DSM).

• The current edition, DSM-5 (2013), was the product of over a decade of research and debates.

• One major issue in DSM-5 development was whether to reduce commitment to a categorical approach.

• Critics question the categorical approach's assumption that people can be reliably placed in discontinuous diagnostic categories.

• There is overlap among disorders' symptoms, and people often qualify for multiple diagnoses.

• Some theorists argue for a dimensional approach, describing disorders in terms of continuous dimensions (e.g., anxiety, depression).

• A dimensional approach presented logistical challenges as experts would have had to agree which dimensions to assess and how to measure them.

• DSM-5 retained a categorical approach, supplementing it with dimensional approaches in some areas.

• Another concern is the DSM's growth. Diagnoses increased from 128 in DSM-I to 541 in DSM-5.

• Some of this growth was due to splitting existing disorders into narrower subtypes, but much of it was due to adding entirely new disorders.

• Some new disorders include behavioral patterns that used to be regarded as mundane, everyday adjustment problems, rather than mental disorders.

• Examples include caffeine intoxication, tobacco use disorder, disruptive mood dysregulation disorder, binge-eating disorder, and gambling disorder.

• Critics argue this "medicalizes" everyday problems and stigmatizes normal self-control issues.

14.2 Anxiety Disorders, OCD, and PTSD

• DSM-5 reorganized the category; OCD and PTSD are now in separate categories.

• For analysis, it makes sense to cover these anxiety-dominated disturbances together.

14.2.1 Generalized Anxiety Disorder

• Marked by chronic, high-level anxiety not tied to any specific threat.

• Constant worry about past mistakes and future problems.

• Anxiety accompanied by physical symptoms (trembling, muscle tension, etc.).

• Lifetime prevalence around 5%; seen twice as much in females as males.

• Typical age of onset is midlife, later than most anxiety disorders.

14.2.2 Specific Phobia

• Troublesome anxiety has a precise focus.

• Involves persistent, irrational fear of an object or situation that presents no realistic danger.

• Examples:

  • Hilda's hailstorm phobia caused by a traumatic experience.

  • Common phobias include acrophobia, claustrophobia, brontophobia, hydrophobia, and animal phobias.

• Phobic reactions accompanied by physical symptoms of anxiety.

• Lifetime prevalence estimated around 10%; two-thirds of victims are females.

14.2.3 Panic Disorder

• Characterized by recurrent attacks of overwhelming anxiety that occur suddenly and unexpectedly.

• Attacks accompanied by physical symptoms of anxiety, sometimes mistaken for heart attacks.

• Victims become apprehensive and hypervigilant, wondering when the next attack will occur.

• About two-thirds of people diagnosed are female; onset typically occurs in late adolescence or early adulthood.

14.2.4 Agoraphobia

• Fear of going out to public places, often due to concern about exhibiting panic in public.

• Experience discomfort in shopping malls, theaters, restaurants, and when using public transport.

• Fear stems from difficulty escaping or getting help if they panic.

• Some manage to venture out with a trusted companion.

• Agoraphobia tends to coexist with panic disorder.

14.2.5 Obsessive-Compulsive Disorder

• Marked by persistent, uncontrollable intrusions of unwanted thoughts (obsessions) and urges to engage in senseless rituals (compulsions).

• Example: Howard Hughes' obsession with germs leading to extraordinary rituals.

• Obsessions often center on inflicting harm on others, personal failures, suicide, or sexual acts.

• Compulsions usually involve stereotyped rituals that temporarily relieve anxiety produced by obsessions.

• Common examples include constant handwashing, repetitive cleaning, and endless rechecking.

• Full-fledged OCD occurs in roughly 2-3% of the population; mean age of onset is 19-20 years.

• OCD can be a very severe disorder; associated with serious social and occupational impairments and a ten-fold increase in the risk for suicide.

• Unusual among anxiety-related problems in that it is seen in males and females in roughly equal numbers.

14.2.6 Post-Traumatic Stress Disorder

• Involves enduring psychological disturbance attributed to the experience of a major traumatic event.

• First recognized as a disorder in the 1970s after the Vietnam War.

• Can be caused by rape/assault, car accidents, natural disasters, or witnessing death.

• Common symptoms include re-experiencing the event, emotional numbing, alienation, social problems, vulnerability, anxiety, anger, and guilt.

• About 7-8% of people are diagnosed with PTSD at some point, but studies using newer DSM-5 criteria have led to even higher estimates.

• PTSD may spike after the COVID-19 pandemic; previous epidemics led to elevated rates of PTSD.

14.2.7 Aetiology of Anxiety-Related Disturbances

• Anxiety disorders develop out of interactions between biological and psychological factors.

Biological Factors

• Concordance rates in twin studies and family studies suggest a moderate genetic predisposition to anxiety disorders.

• Disturbances in neural circuits using GABA (gamma-aminobutyric acid) and serotonin may play a role in some types of anxiety disorders.

Conditioning and Learning

• Many anxiety responses can be acquired through classical conditioning and maintained through operant conditioning.

• A neutral stimulus can be paired with a frightening event, becoming a conditioned stimulus eliciting anxiety.

• Avoidance of the anxiety-producing stimulus is negatively reinforced because it reduces anxiety.

• Studies find that a substantial portion of people reporting phobias can identify a traumatic conditioning experience.

• People vary in how easily they develop conditioned fears.

• Preparedness (Martin Seligman): People are biologically prepared to acquire some fears more easily than others.

• Evolved module for fear learning (Öhman & Mineka): Automatically activated by stimuli related to past survival threats and relatively resistant to intentional suppression.

• Distortions in the process of generalisation in classical conditioning may also contribute to anxiety disorders.

• Patients with panic disorder and those with PTSD both have a tendency to over-generalise, that is to have broader generalisation gradients than control subjects, when exposed to stimuli that trigger anxiety.

Cognitive Factors

• Certain styles of thinking make some people vulnerable to anxiety disorders.

  1. Misinterpreting harmless situations as threatening.

  2. Focusing excessive attention on perceived threats.

  3. Selectively recalling threatening information.

• Anxious subjects were more likely to interpret sentences in a threatening light.

• Researchers have also linked OCD to deficits in what is called executive function.

• Executive function refers to the basic cognitive processes that support self-regulation, planning and decision making.

Stress

• PTSD is attributed to exposure to extremely stressful incidents.

• Various anxiety disorders can be related to stress.

• Stress levels are predictive of the severity of OCD patients' symptoms.

• High stress often helps to trigger or aggravate anxiety-related disorders.

14.3 Dissociative Disorders

• The most controversial set of disorders in the diagnostic system.

• People lose contact with portions of their consciousness or memory, resulting in disturbances in their sense of identity.

• Two syndromes: dissociative amnesia and dissociative identity disorder.

14.3.1 Description

• Dissociative Amnesia: Sudden loss of memory for important personal information that is too extensive to be due to normal forgetting.

• Memory losses can occur for a single traumatic event or for an extended period surrounding the event.

• Amnesia observed after disasters, accidents, war stress, physical abuse, and rape.

• People may forget their name, family, where they live/work, but remember unrelated matters and can form new memories.

• Dissociative Identity Disorder (DID): Disruption of identity marked by the experience of two or more largely complete, and usually very different, personalities.

• Formerly called multiple personality disorder.

• Individuals fail to integrate incongruent aspects of their personality into a coherent whole.

• Each identity may have its own name, memories, traits, physical mannerisms, and autonomy.

• DID patients often exhibit somatic symptoms, self-harm behaviors, and hallucinations.

• DSM-5 added possession-related phenomena to DID category.

• Dramatic increase in DID diagnoses starting in the 1970s; some theorists believe it used to be underdiagnosed, others believe it is being overdiagnosed.

14.3.2 Aetiology of Dissociative Disorders

• Dissociative amnesia is usually attributed to excessive stress but relatively little is known about why this extreme reaction to stress occurs in a tiny minority of people.

• Causes of DID are particularly obscure.

• Skeptical theorists believe people with multiple identities,Thanks to book and movie portrayals of dissociative identity disorder and reinforcement from their therapists, come to believe that independent entities within them are to blame for their peculiar behaviors.

• Clinicians convinced DID is an authentic disorder argue there is no incentive to manufacture cases and most cases originate from severe emotional trauma during childhood.

• A substantial majority of people with dissociative identity disorder do report a childhood history of rejection from parents and of physical and sexual abuse or other forms of trauma.

• In the final analysis, little is known about the causes of dissociative identity disorder, which remains a controversial diagnosis.

14.4 Depressive and Bipolar Disorders

• Mood disorders marked by disabling emotional dysfunction.

• However, tend to be episodic, allowing for periods of normality.

Key Learning Goals

• Symptoms of major depressive disorder and bipolar disorder and their relation to suicide.

• How genetic, neural, cognitive, social, and stress factors relate to the development of disorders.

Patterns

• Major depressive disorder: emotional extremes at one end of mood continuum.

• Bipolar disorder: emotional extremes at both ends of the mood continuum.

14.4.1 Major Depressive Disorder

• Persistent feelings of sadness and despair, loss of interest in previous sources of pleasure.

• Central feature is anhedonia (diminished ability to experience pleasure).

• Common symptoms: reduced appetite, insomnia, sluggish movement, slow talk, anxiety, and hopelessness.

• Average age of onset is around 30-35 (but can occur at any point).

• Most estimates suggest that about two-thirds of the people who are diagnosed with major depression experience more than one episode over the course of their lifetime

• Average episode lasts about six months.

• Associated with elevated risk for health problems and mortality.

• Lifetime prevalence estimated to be around 13-16%.

• The prevalence of depression is about twice as high in women as it is in men

• Some theorists believe that a substantial portion of the people who meet the DSM criteria for major depression would be better characterized as experiencing normal, although intense and unpleasant, reactions to severe stressful events

14.4.2 Bipolar Disorder

• Experience of both depressed and manic periods.

• Manic symptoms are generally the opposite of depressive symptoms.

• Manic episode: elevated mood, euphoria, inflated self-esteem, hyperactivity, and impaired judgment.

• Bipolar I disorder involves full manic episodes; bipolar II involves milder hypomanic episodes.

• Unlike depression, bipolar disorders are seen equally often in males and females.

• Typical age of onset is in the late teens/early 20s.

14.4.3 Mood Dysfunction and Suicide

• A tragic problem associated with mood disorders.

• Accounts for 8% of all deaths per year in South Africa, but is likely much higher.

• Women attempt suicide three times more often than men, but men complete four times as many suicides as women.

• About 90% of suicide victims have some type of psychological disorder.

• Suicide rates are highest for people with depressive and bipolar disorders.

Suicide Prevention Tips

1. Take suicidal talk seriously.

2. Provide empathy and social support.

3. Identify and clarify the crucial problem.

4. Do not promise to keep someone's suicidal ideation secret.

5. In an acute crisis, do not leave a suicidal person alone.

6. Encourage professional consultation.

14.4.4 Aetiology of Depressive and Bipolar Disorders

Genetic Vulnerability

• Genetic factors influence the likelihood of developing major depression and bipolar disorder.

• Heritability of bipolar disorder is around 65-80%; heritability of depression is around 40%.

• Heredity can create a predisposition or vulnerability to mood dysfunction.

Neurochemical and Neuroanatomical Factors

• Mood disorders correlate with abnormal levels of norepinephrine and serotonin in the brain.

• Low serotonin levels appear to be a factor underlying most forms of depression.

• Depression has also been linked to reduced hippocampal volume (especially in the dentate gyrus).

• New theory: depression occurs when major life stress suppresses neurogenesis (new neuron generation) in the hippocampal formation.

• High reactivity in the amygdala (key role in learning fear responses) may be a factor in depression.

• Reduced activation in brain areas that process reward may be the neural basis for anhedonia.

Cognitive Factors

• Cognitive processes contribute to depressive disorders.

• Seligman proposed that depression is caused by learned helplessness (passive "giving up" behavior).

• People with a pessimistic explanatory style are especially vulnerable to depression.

• They attribute setbacks to personal flaws instead of situational factors.

• Nolen-Hoeksema: people who ruminate about their depression remain depressed longer.

• Hindsight bias may also fuel depression by making negative outcomes seem more foreseeable.

Interpersonal Roots

• Social difficulties put people on the road to depressive disorders.

• Depression-prone people lack the social subtlety needed to acquire reinforcers like good friends and top jobs.

• Depressed people unintentionally elicit rejection because they are irritable, pessimistic, and unpleasant.

• They alienate people by constantly asking for reassurance about their relationships.

• Poor social skills and difficult social relations increase stress.

Precipitating Stress

• Stress can trigger both major depression and bipolar disorder.

• Severe, aversive stressors are more likely to trigger depression than less severe stressors.

• Vulnerability to depression increases as people go through more recurrent episodes.

14.5 Schizophrenic Disorders

• Means "split mind," referring to fragmentation of thought processes, not a split personality.

• Schizophrenia: a disorder marked by delusions, hallucinations, disorganized thinking and speech, and deterioration of adaptive behavior.

• Emerges during adolescence or early adulthood.

• About 1% of the population may be diagnosed with schizophrenia over the course of their lives.

• Costly illness for society due to severity, early onset, and need for lengthy hospital care.

• Increased risk for suicide and premature mortality from physical diseases.

Key Learning Goals

• General characteristics of schizophrenia.

• Distinguish between positive and negative symptoms.

• How genetic and neural factors contribute to development.

• Neurodevelopmental hypothesis.

• How family dynamics and stress play a role.

14.5.1 Symptoms

• Thinking can be bizarre; the disorder can be severe and disabling.

• Symptoms include:

  • Delusions and Irrational Thought: False beliefs that are maintained even when they are out of touch with reality; delusions of persecution seen in about 80% of patients with schizophrenia.

  • Deterioration of Adaptive Behavior: obvious deterioration in the quality of the person's routine functioning in work, social relations and personal care.

  • Distorted Perception: auditory hallucinations reported by about 70% of patients.

  • Disturbed Emotion: flattening of emotions; emotional responses that do not fit the situation; or emotional instability.

14.5.2 Aetiology of Schizophrenia

Genetic Vulnerability

• Hereditary factors play a role.

• Concordance rates for identical twins average around 48%, compared to about 17% for fraternal twins.

• Theorists suspect genetic factors may account for as much as 80% of the variability in susceptibility to schizophrenia.

• Genetic vulnerability may be heightened when accompanied by relatively low general intelligence.

Neurochemical Factors

• Excess dopamine activity is the neurochemical basis for schizophrenia (dopamine hypothesis).

• Most drugs useful in treating schizophrenia lower dopamine activity in the brain.

• Elevated dopamine in some areas may promote positive symptoms, reduced dopamine in others may promote negative symptoms.

• Dopamine dysregulation is linked to disturbances in other neurotransmitter systems (serotonin, GABA, glutamate).

• Research suggests that marijuana use during adolescence may help precipitate schizophrenia in young people with a genetic vulnerability to the disorder.

Structural Abnormalities in the Brain

• Individuals with schizophrenia display deficits in attention, perception, working memory, and information processing.

• Cognitive deficits suggest schizophrenic disorders may be caused by neurological defects.

• CT scans and MRI scans associate enlarged brain ventricles with schizophrenic disturbance, show the degeneration of nearby brain tissue..

• meta-analysis of MRI studies of over 2 000 schizophrenia patients, Patients were found to have a smaller hippocampus, thalamus and amygdala than comparable control subjects

• Synaptic pruning, the selective elimination of synapses by certain types of glial cells, going wrong.

The Neurodevelopmental Hypothesis

• Schizophrenia is partly caused by disturbances in normal maturational processes of the brain before or at birth.

• Insults to the brain during sensitive phases of prenatal development or birth can cause subtle neurological damage that elevates individuals' vulnerability to schizophrenia years later.

• Research has focused on viral infection or malnutrition during prenatal (before birth) development and on obstetrical complications during the birth process.

Expressed Emotion

• Expressed emotion is mainly focused on how its effects the family dynamics in the course of schizophrenic illness, after the onset of the disorder

• Expressed emotion is the degree to which a relative of a schizophrenic patient displays highly critical or emotionally overinvolved attitudes toward the patient.

• Family's expressed emotion is a good predictor of the course of a schizophrenic patient's illness.

• Patients returning to homes high in expressed emotion have relapse rates three times higher than those returning to homes low in expressed emotion.

Stress

• Stress plays a key role in triggering schizophrenic disorders.

• Various biological and psychological factors influence individuals' vulnerability to schizophrenia.

• High stress can trigger a schizophrenic disorder in someone who is vulnerable or trigger relapses.

14.6 Autism Spectrum Disorder

• Diagnosed almost exclusively during childhood.

• Characterized by deficits in social interaction and communication + restricted, repetitive interests/activities.

14.6.1 Symptoms and Prevalence

• Early symptoms: minimal eye contact, declining social interest, delays in language development, repetitive movements, and hyper-reactivity to stimuli.

• Verbal communication is impaired in 30-40% of children with classic autism.

• Inflexible and minor changes in their environment can trigger meltdowns and shutdowns.

• Some children show self-injurious behavior.

• About one half have subnormal IQ scores.

• Difficulties processing others' emotions, regulating their emotions, and building friendships.

• Parents typically become concerned by 15-18 months and seek consultation by 24 months.

14.6.2 Aetiology of ASD

• Originally blamed on cold, distant parenting (discredited).

• Today viewed as originating in biological dysfunctions.

• Twin studies and family studies have demonstrated that genetic factors make a major contribution to ASD.

• Associated with generalized brain enlargement that is seen by age two

• Theorists speculate that this overgrowth probably produces disturbances in neural circuits.

• The 1998 study that first reported a link between vaccinations and autism has been discredited as fraudulent.

• Independent efforts to replicate the claimed association between vaccinations and ASD have consistently failed.

14.7 Personality Disorders

• Extreme, inflexible personality traits that cause subjective distress or impaired social and occupational functioning.

• Become recognizable during adolescence or early adulthood.

• Lifetime prevalence is in the vicinity of 10%.

• DSM-5 lists 10 personality disorders grouped into anxious/fearful, odd/eccentric, and dramatic/impulsive clusters.

• Often associated with significant impairments of social and occupational functioning.

• Associated with striking reductions (18-19 years) in life expectancy.

14.7.1 Antisocial, Borderline, and Narcissistic Personality Disorders

• Antisocial Personality Disorder:Impulsive, callous, manipulative, aggressive, and irresponsible behavior; people with antisocial personalities rarely feel guilty about their behavior.

• Borderline Personality Disorder:Instability in social relationships, self-image, and emotional functioning; switch back and forth between idealising people and devaluing them.

• Narcissistic Personality Disorder:A grandiose sense of self-importance, a sense of entitlement and an excessive need for attention and admiration people with this disorder think they are unique and superior to others.

14.7.2 Aetiology of Personality Disorders

• Interactions between genetic predispositions and environmental factors.

• Personality disorders are influenced by heredity.

• Contributing factors vary between disorders (e.g., dysfunctional family systems for antisocial personality disorder; history of trauma for borderline personality disorder).

14.8 Eating Disorders

• Severe disturbances in eating behavior characterized by preoccupation with weight concerns and unhealthy efforts to control weight are not taken seriously enough.

• Three syndromes: anorexia nervosa, bulimia nervosa, and binge-eating disorder.

14.8.1 Description

• Anorexia Nervosa: Intense fear of gaining weight, disturbed body image, refusal to maintain normal weight, and use of dangerous measures to lose weight; have a disturbed body image. No matter how frail they become, they insist that they are too fat

• Bulimia Nervosa: Habitually engaging in out-of-control overeating, followed by unhealthy compensatory efforts, such as self-induced vomiting are much more likely to recognize that their eating behaviour is pathological and are and are more likely to cooperate with treatment.

• Binge-Eating Disorder: Distress-inducing eating binges that are not accompanied by purging, fasting, or excessive exercise binge-eating disorder creates great distress.

14.8.2 Prevalence and Cultural Roots

• Have been viewed as a product of modern, affluent Western culture.

• Advances in communication have exported modern Western culture to all corners of the globe Eating disorders.

• Are increasingly diagnosed, especially in affluent Asian countries such as South Africa; ethnicity does not necessarily protect people from developing disordered eating behaviors.

14.8.3 Aetiology of Eating Disorders

• Multiple determinants work interactively in causing the disorders.

• Contributing factors:

  • genetic vulnerability to inheritance the disorders if you inherit from your parents

  • personality traits is being more perfectionism and having rigidity

  • cultural values can be linked to ethnicity and race etc

  • role of the family from sexual abuse

  • cognitive factors related to eating.

14.9 New Directions in the Study of Psychological Disorders

• Two interesting new findings have emerged that apply to a wide range of disorders: that early-life stress may elevate vulnerability, and that seemingly distinct disorders may share more genetic/neurobiological roots than previously thought.

14.9.1 The Role of Early-Life Stress in Adult Disorders

• Recent research has explored how severe stress in early childhood may increase individuals' vulnerability to various disorders many years later,

• Numerous studies have linked early-life stress to an increased prevalence of anxiety disorders. Dissociative disorders. Depressive disorders bipolar disorder

• Schizophrenic disorders, personality disorder And eating disorders. So, more evidence is needed to establish causality, but the sheer number and consistency of the findings suggest that childhood trauma may have long-term ripple effects that increase individuals'

• Vulnerability to a broad range of psychological disorders.

• Adversity may alter critical features of developing brain structure and the reactivity of the HPA axis that regulates hormonal responses to stressors.

14.9.2 Genetic Overlap Among Major Disorders

• Findings suggest an overlap between of Genetic variations that each disorder may also be closely linked, Such has depression and schizophrenia in other words all those various disorders are very much in lined with similar characteristics between all the different diseases,

14.10 Culture and Pathology

• Judgements of normality and abnormality are influenced by cultural norms and values.

• Social scientists are divided on whether psychological disorders are culturally variable or universal.

• Relativistic view: criteria of mental illness vary greatly across cultures, western, and reflect Ethnocentric

• Pancultural view: criteria of mental illness are much the same worldwide, and Western diagnostic concepts have validity and usefulness in other cultural contexts., And has both the specific and the the two viewpoints are two very different and separate ideas of what psychology is when you add our culture.

14.10.1 Are Equivalent Disorders Found Around the World?

• Most investigators agree that the main categories of serious psychological disturbances - schizophrenia, depression and bipolar illness - are identifiable in all cultures.

• Most behaviors that are regarded as clearly abnormal in Western culture are also viewed as abnormal in other cultures.

• Cultural variations are more apparent in the recognition of less severe forms of psychological disturbance which do not disrupt behavior in obvious ways, are not labelled as disorders in many societies, culture to culture with how we approach it with it

14.10.2 Traditional African Models of Abnormal Behavior: The Influence of Culture on symptom patterns and psychology with it.

• As judgements of normality and normality are influenced by cultural norms which determine the ways in which illness is defined and treated.

• African or indigenous traditional healing involves a different understanding of mental health.

• This kind of worldview considers the universe to be made up of networks of life energy and/or spirit forces, where mental distress is often related to spiritual dimensions

14.11 Reflecting on the Chapter's Themes

• Our examination of abnormal behavior and its roots has highlighted four of our organizing themes: multifactorial causation, the interplay of heredity and environment, the sociohistorical context in which psychology evolves, and the influence of culture on psychological phenomena. Each of those themes are organized by multifactorial causes And psychological components.