Psychological Disorders

Psychological Disorders

Chapter Overview

  • Definition and Classification of Psychological Disorders

  • Categories of Disorders:

    • Anxiety-Related Disorders

    • Substance Use Disorders

    • Depressive Disorders and Bipolar Disorders

    • Schizophrenia

    • Dissociative, Personality, and Eating Disorders

    • Risk of Harm to Self and Others

    • Neurodevelopmental Disorders

What Is a Psychological Disorder?

  • Key Questions Addressed:

    • How should we define psychological disorders?

    • How should we understand disorders?

    • How should we classify psychological disorders?

Defining Psychological Disorders

  • Definition:

    • A psychological disorder represents a disturbance in a person's thoughts, emotions, or behaviors that causes distress or suffering and impairs daily life.

  • Key Characteristics:

    • Dysfunctional/Maladaptive Behaviors: Behaviors that do not contribute positively to life functioning.

    • Distress: Symptoms that cause significant discomfort to individuals.

    • Deviation from Social Norms: Behaviors that are atypical or violate societal expectations, referred to as the "Refrigerator Mother Theory" which connects parenting styles with psychological outcomes in children.

Understanding Psychological Disorders

  • Historical Context:

    • Individuals with psychological disorders have faced severe treatments throughout history:

    • Stone Age: Skull drilling as an early form of treatment.

    • Bedlam Asylum in London (1247): Known for brutal conditions.

    • Lobotomy (Early 1900s): A surgical removal of brain tissue as treatment.

Medical Model

  • Definition:

    • The medical model emphasizes the diagnosis and treatment of diseases through physiological causes.

  • Strengths:

    • Reduces stigma associated with mental illness.

    • Contributes to effective treatment options.

  • Criticisms:

    • Considered reductionist, oversimplifying complex human behavior.

    • Encourages paternalism, implying that individuals cannot manage their own mental health.

    • Views issues as "defects" to be fixed.

Biopsychosocial Approach

  • Definition:

    • This model suggests that an individual's biological, psychological, and social-cultural environments interact to shape their behaviors, thoughts, and feelings.

  • Components of the Approach:

    • Vulnerability-Stress Model: Proposes that psychological disorders develop when stress overwhelms an individual's coping mechanisms.

    • Epigenetics: The study of how environments can influence gene expression, impacting psychological conditions.

Classifying Disorders

  • Purpose of Classification:

    • Predict the future course of a disorder.

    • Suggest appropriate treatments.

  • The DSM-5:

    • Published by the American Psychiatric Association in 2013.

    • Includes diagnostic codes used in the WHO's International Classification of Diseases (ICD).

  • Issues and Criticisms of DSM-5:

    • Labels can be self-fulfilling, impacting perception and treatment of those diagnosed (Snyder, 1984).

    • Individuals with diagnoses may experience stigmatization, leading to reluctance in seeking help (Corrigan, 2014).

    • Diagnosis variability exists; some disorders lack clear biological markers (Freedman, 2013).

    • The DSM-5 may be overly inclusive, possibly encompassing conditions such as grief.

Anxiety-Related Disorders

  • Overview of Anxiety Disorders:

    • General Anxiety Disorder (GAD)

    • Obsessive-Compulsive Disorder (OCD)

    • Post-Traumatic Stress Disorder (PTSD)

    • Somatic Symptom Disorders

General Anxiety Disorder (GAD)

  • Characteristics:

    • Persistent and difficult to control feelings of worry.

    • Manifests physical symptoms (e.g., excessive sweating, heart palpitations).

    • Severity varies among individuals.

Social Anxiety Disorder (Social Phobia)

  • Characteristics:

    • Intense fear of social or performance situations.

    • Physical symptoms similar to GAD with an emphasis on fear of judgment from others.

  • The distinction: Excessive worry is present in both GAD and social anxiety disorder but with different triggers.

Panic Disorder and Phobias

  • Panic Disorder:

    • Characterized by intense, irrational fear often linked to physical symptoms (e.g., dizziness, hyperventilation).

    • Fear that something terrible is about to happen, which may lead to agoraphobia.

  • Specific Phobias:

    • Persistent, irrational fears of certain objects or situations, leading to avoidance behaviors (e.g., fear of heights, animals).

Obsessive-Compulsive Disorder (OCD)

  • Definition:

    • Characterized by unwanted, repetitive thoughts (obsessions) and/or actions (compulsions).

  • Compulsions are often responses to obsessions.

  • Disorder develops when obsessions interfere with daily life and well-being.

  • Related Disorders:

    • Body Dysmorphic Disorder

    • Trichotillomania (compulsive hair pulling)

    • Excoriation (skin-picking disorder)

Post-Traumatic Stress Disorder (PTSD)

  • Characteristics:

    • Encompasses haunting memories, nightmares, and hypervigilance.

    • Individuals may avoid trauma-related stimuli.

    • Common in veterans but present across various demographics.

    • Associated with concepts like survivor resiliency and post-traumatic growth.

Somatic Symptom Disorders

  • Definition:

    • Physical symptoms that cannot be traced to any medical condition.

  • Types:

    • Somatic Symptom Disorder

    • Illness Anxiety Disorder

    • Conversion Disorder (historically referenced as female hysteria by Freud)

    • Factitious Disorder

Understanding Anxiety-Related Disorders

  • Insights into the Origins of Anxiety:

    • Conditioning: Involves stimulus generalization and reinforcement learning.

    • Cognition: Influenced by social learning and irrational thoughts.

    • Biological Factors: Includes genetic predispositions and neurological changes.

Questions in Anxiety Research

  • Examining Variability in Fear Responses:

    • Why does Alex Honnold, an experienced climber, exhibit no fear of heights compared to most people?

    • Explore the role of the amygdala in fear responses as further study.

Substance Use Disorders

  • Definition:

    • Characterized by the continued use of substances despite facing significant life disruptions.

  • Types of Psychoactive Drugs:

    • Depressants: Slow neural activity; examples include alcohol and opioids.

    • Stimulants: Speed up neural activity; examples include caffeine and cocaine.

    • Hallucinogens: Distort perceptions; examples include LSD and psilocybin mushrooms.

Specific Types of Psychoactive Drugs

  • Depressants:

    • Includes alcohol, barbiturates (tranquilizers), and opioids, which calm neural functions and alleviate pain/anxiety.

  • Opioids:

    • Include heroin and prescribed pain-relievers (e.g., morphine, OxyContin).

    • Operate by depressing nervous system activity.

  • Stimulants:

    • Examples include caffeine, nicotine, and powerful stimulants like methamphetamine.

    • Result in feelings of alertness, energy elevation, but also carry addiction risks.

Influences on Substance Use Disorders

  • Biological Influences:

    • The role of genetics in predisposition to addiction.

  • Psychological Influences:

    • Trauma or history of abuse can increase risk.

  • Social-Cultural Influences:

    • Peer pressure and cultural context can impact substance use behaviors.

Depressive Disorders and Bipolar Disorders

  • Prevalence of Depression:

    • An estimated 21.0 million adults in the U.S. experienced at least one major depressive episode.

Symptoms of Depression

  • Emotional Symptoms:

    • Sadness, loss of interest or pleasure, feelings of being overwhelmed, anxiety, and excessive guilt.

  • Physical Symptoms:

    • Vague aches and pains, sleep disturbances, fatigue, and significant changes in appetite leading to weight fluctuations.

Beck's Depression Inventory

  • A self-scored tool for assessing depression severity.

  • Items range from feelings of sadness to thoughts of self-harm.

  • Responses rate the intensity of feelings on a scale from 0 to 3.

Different Forms of Depression

  • Major Depressive Disorder

  • Persistent Depressive Disorder

  • Premenstrual Dysphoric Disorder

  • Postpartum Depression

  • Seasonal Affective Disorder

Bipolar Disorder

  • Definition:

    • Characterized by oscillation between depressive states and manic states.

    • Bipolar I involves full-blown manic episodes, while Bipolar II involves hypomanias.

  • Suicide Risk: Individuals with bipolar disorder are at 20-30 times higher risk for self-harm.