14.1 Psychopathology: Classification and Causes

• Mental disorder: A significant impairment in psychological functioning.

• Psychopathology: The scientific study of mental, emotional, and behavioral disorders; the term is also used to refer to maladaptive behavior.

  Defining Abnormality

• Statistical abnormality: Abnormality defined on the basis of an extreme score on some dimension, such as IQ or anxiety.

• Social nonconformity: Failure to conform to societal norms or the usual minimum standard for social conduct.

• Maladaptive (behavior): Behavior arising from an underlying psychological or biological dysfunction that makes it difficult to adapt to the environment and meet the demands of day-to-day life.

  Classifying Mental Disorders: The DSM-5

• Comorbid (in mental disorders): The simultaneous presence in a person of two or more mental disorders.

  Psychiatric Classification in Everyday Life: The Insanity Defense

• Insanity: A legal term that refers to a mental inability to manage one’s affairs or to be aware of the consequences of one’s actions.

  Causes of Mental Illness

  Biological Factors

• Neurodevelopmental disorders: Psychopathologies due to various forms of damage to the nervous system arising before adulthood.

• Neurocognitive disorders: Psychopathologies due to various forms of damage to the nervous system not arising until adulthood.

• Alzheimer’s disease: Age-related condition characterized by memory loss, confusion, and increasing loss of mental abilities.

• Psychological trauma: A psychological injury or shock, such as that caused by violence, abuse, neglect, separation, etc.

  Stress-Vulnerability Model

• Stress-vulnerability (diathesis-stress) model: A model that attributes mental illness to a combination of environmental stress and inherited susceptibility.

  14.2 Psychotic Disorders

• Psychosis (Psychoses): A withdrawal from reality marked by hallucinations and delusions, disturbed thoughts and emotions, and personality disorganization.

• Schizophrenia spectrum and other psychotic disorders: Severe mental disorders characterized by delusions, hallucinations, disturbed thought and/or speech, disturbed motor behavior, and/or retreat from reality.

  Delusional Disorders

• Hallucination: Perception with no basis in reality.

• Delusional disorder: A psychosis marked by severe delusions of grandeur, jealousy, persecution, or similar preoccupations.

• Delusion: Strongly held thought or belief that is at odds with reality.

• Most Common Types of Delusions:

  • Erotamanic type

    • believe they are loved by another person who is usually famous

  • Grandiose type

    • believe they have a great unrecognized talent or knowledge

    • believe they have a special relationship with God or that they are famous

  • Jealous type

    • believe significant other is unfaithful

  • Persecutory type

    • believe you are being conspired against, cheated or spied on, followed, or harassed

  • Somatic type

    • believe bodies are rotting, diseased, infected, or infested by insects or parasites

• Paranoid psychosis: A delusional disorder centered especially on delusions of persecution.

  Schizophrenia

• Schizophrenia: Severe disorder characterized by disturbances in thought, perceptions, emotions, and behavior.

  Symptoms of Schizophrenia

  • Disturbed Thinking

• Paranoia: A symptom marked by a preoccupation with delusions related to a single theme, especially grandeur or persecution.

  • Disturbed Perception

  • Disturbed Emotions

  • Disturbed Behavior

• Catatonia: A disorder marked by stupor, rigidity, unresponsiveness, posturing, mutism, and sometimes agitated, purposeless behavior.

  Cause of Schizophrenia

  • Psychosocial factors

  • Genetics

  • Brain functioning

  14.3 Mood and Personality Disorders

  Mood Disorders

  Depressive Disorders

• Depressive disorders: Class of disorders marked by chronic feelings of sadness and despondency.

• Persistent depressive disorder (dysthymia): Moderate depression that persists for two years or more.

• Major depressive disorder: Mood disorder in which the person has suffered one or more intense episodes of depression.

• Seasonal affective disorder (SAD): Depression that occurs only during fall and winter; presumable related to decreased exposure to sunlight.

  • Phototherapy: A treatment for SAD that involves exposure to bright, full-spectrum light.

  Bipolar and Related Disorders

• Bipolar and related disorders: Mood disorders characterized by alternating periods of mania and depression.

• Manic episode: Period of abnormally excessive energy and elation.

• Cyclothymic disorder: Moderate manic and depressive behavior that persists for two years or more.

• Bipolar I disorder: A mood disorder in which a person has episodes of mania (excited, hyperactive, energetic, or grandiose behavior) and also periods of deep depression.

• Bipolar II disorder: A mood disorder in which a person is mostly depressed (sad, despondent, guilt-ridden) but also has had one or more episodes of mild mania (hypomania).

  Causes of Mood Disorders

  • Biology and Depression

  • Gender and Depression

• Postpartum depression: A mild to moderately severe depression that begins within three months following childbirth.

  Mood Disorders in Everyday Life: Suicide

• Factors Affecting Suicide Rates:

  • Sex

  • Ethnicity

  • Age

  • Martial Status

  Personality Disorders

• Personality disorders: Long-standing, inflexible ways of behaving that create a variety of problems.

• Antisocial personality disorder: Unusual remorselessness, lack of empathy, or disregard for social conventions.

  14.4 Anxiety and Anxiety-Related Disorders

  Anxiety Disorders

• Anxiety disorders: Class of disorders marked by feeling of excessive apprehension and worry.

• Generalized anxiety disorder: Psychological disorder characterized by nearly constant, exaggerated worries.

• Panic disorder: Chronic state of anxiety, with brief moments of sudden, intense, unexpected panic.

• Phobia: Persistent, excessive, and unrealistic fear that is triggered by specific objects or people.

• Agoraphobia: The fear that something extremely embarrassing will happen if one leaves the house or enters an unfamiliar situation; excessive, irrational fear of being in public places.

• Social anxiety disorder: An intense, irrational fear of being observed, evaluated, embarrassed, or humiliated by others in social situations.

• Specific phobia: Persistent fear and avoidance of a specific object or situation.

  Theoretical Approaches to Anxiety Disorders

  • Psychodynamic Approach

  • Humanistic Approaches

  • Behavioral Approach

• Anxiety reduction hypothesis: Explains the self-defeating nature of avoidance responses as a result of the reinforcing effects of relief from anxiety.

  • Cognitive Approach

  Anxiety-Related Disorders

  Obsessive-compulsive and related disorders

• Obsessive-compulsive and related disorders: Extreme preoccupations with certain thoughts and compulsive performance of certain behaviors.

• Obsessive-compulsive disorder (OCD): An extreme preoccupation with certain thoughts and compulsive performance of certain behaviors.

• Hoarding disorder: Excessively collecting various things.

  Trauma-and stressor-related disorders

• Trauma-and stressor-related disorders: Behavior patterns brought on by traumatic stresses.

• Adjustment disorder: Emotional disturbance caused by ongoing stressors within the range of common experience.

• Acute stress disorder: A psychological disturbance lasting up to one month following stresses that would produce anxiety in anyone who experienced them.

• Post-traumatic stress disorder (PTSD): Pattern of unwanted memories, nightmares, and flashbacks following a traumatic event for more than a month.

  Dissociative Disorders

• Dissociative disorders: Class of psychological disorders involving disintegration of consciousness, memory, or self-identity.

• Dissociative amnesia: Loss of memory (partial or complete) for important information related to personal identity.

• Dissociative fugue: Sudden travel away from home, plus confusion about one’s personal identity.

• Dissociative identity disorder: Presence of two or more distinct personalities (multiple personality).

  Somatic Symptom and Related Disorders

• Somatic symptom and related disorders: Physical symptoms that mimic disease or injury (e.g., paralysis, blindness, illness, or chronic pain) for which there is no identifiable physical cause.

• Somatic syndrome disorder: Exhibiting the characteristics of a disease or injury without an identifiable physical cause.

• Factitious disorder: (Munchausen syndrome) To gain attention, an affected person fakes his or her medical problems or those of someone in his or her care.

• Conversion disorder: A bodily symptom that mimics a physical disability but is actually caused by anxiety or emotional distress.

  14.5 Psychology and Your Skill Set: Perseverance

• Grit is a better predicted of success than intelligence

  Measuring Grit

  • Interest

  • Practice

  • Purpose and Hope

Chapter in Review:

14.1 Psychopathology: Classifications and Causes

14.1.1 Describe four things to consider when deciding whether behavior is abnormal

When deciding whether behavior is abnormal, we can consider statistical abnormality, nonconformity, subjective discomfort, and the extent to which the behavior may be considered maladaptive

14.1.2 Explain how psychological disorders are classified and diagnosed

Psychological problems are classified by using the Diagnostic and Statistical Manual of Mental Disorders (5th Edition) (DSM-5), and it is possible for people to be comorbid (i.e., exhibiting symptoms that fit more than one disorder). The DSM is updated regularly, and categories can be added, deleted, or changed based on an evolving understanding of disorders and changes in social norms.

Mental illness is typically diagnosed by confirming the presence and/or absence of a number of symptoms. Symptoms can be divided into those that are positive (i.e., exaggeration compared to normal behavior) and those that are negative (i.e., deficit compared to normal behavior).

14.1.3 Describe the causes of mental disorders and the importance of the stress-vulnerability model

Mental disorders may be due to genetic factors, known injuries, or diseases of the brain. Psychosocial factors that contribute to psychopathology include psychological factors, family factors, and social conditions. A promising explanation for many mental illnesses is the stress-vulnerability model, which emphasizes a combination of inherited susceptibility and environmental or social stress.

14.2 Psychotic Disorders

14.2.1 Describe the general characteristics of psychotic disorders

Psychosis is a break in contact with reality that is marked by delusions, hallucinations, sensory changes, disturbed emotions, disturbed communication, and personality disintegration.

14.2.2 Outline the specific characteristics of delusional disorders

Delusional disorders are almost totally based on the presence of deeply held false beliefs of grandeur, persecution, infidelity, romantic attraction, or physical disease. Paranoid psychosis is the most common delusional disorder. Paranoid persons may be violent if they believe that they are threatened.

14.2.3 Outline the specific characteristics of schizophrenia

Schizophrenia spectrum disorder involves varying degrees of abnormal cognition (delusions, paranoia), perceptions (hallucinations), abnormal mood (flat or inappropriate affect), abnormal behavior (inability to cope, catatonia)m and a disintegrated personality.

14.2.4 Describe the causes of schizophrenia

Environmental factors that increase the risk for schizophrenia include viral infection or malnutrition during the mother’s pregnancy and birth complications. Psychosocial factors include early psychological trauma and a disturbed family environment. Heredity is a major factor in schizophrenia. Recent biochemical studies have focused on the neurotransmitters glutamate and dopamine and their receptor sites. The stress-vulnerability model currently offers the best general explanation for schizophrenia.

14.3 Mood and Personality Disorders

14.3.1 Describe the general characteristics of mood disorders

Mood disorders primarily involve disturbances of mood or emotion, producing manic or depressive states. Severe mood disorders may include psychotic features.

14.3.2 Outline the specific characteristics of depression and bipolar disorders

In a persistent depressive disorder (dysthymia), depression is long-lasting but moderate. In contrast, major depressive disorder involves extreme sadness and despondency. One specific type of depression, seasonal affective disorder (SAD), occurs during the winter months, and is typically treated with phototherapy. Bipolar disorders combine mania and depression. In a cyclothymic disorder, people suffer from long-lasting, though moderate, swings between depression and elation. In a bipolar I disorder, the person fluctuates between severe mania and severe depression. In a bipolar II disorder, the person is mostly depressed but has had periods of mild mania.

14.3.3 Describe the mood disorders, including their risk factors

Mood disorders are partially explained by genetic vulnerability and changes in brain chemistry. Mood disorders also are partially explained by psychological factors such as loss, anger, learned helplessness, stress, and self-defeating thinking patterns. Gender is one important risk factor. Women are more likely than men to become depressed owing to hormonal fluctuations and stressful social and environmental conditions (including childbirth, which can lead to postpartum depression).

14.3.4 Outline some of the factors that lead people to commit suicide

In individual cases, the potential for suicide is best identified by a desire to escape, unbearable psychological pain, and frustrated psychological needs. Suicide is a statistically related to such factors as sex, ethnicity, age, and marital status.

14.3.5 Describe the general characteristics of personality disorder, and the specific features of antisocial personality disorder

Personality disorders are persistent, maladaptive personality patterns. Antisocial personalities seem to lack a conscience. They are emotionally unresponsive, manipulative, shallow, and dishonest. Psychopathy may be an extreme form of antisocial personality disorder.

14.4 Anxiety and Anxiety-Related Disorders

14.4.1 Describe the general characteristics of anxiety disorders

Anxiety disorders are characterized by high levels of anxiety, rigid defense mechanisms, and self-defeating behavior patterns. Anxiety disorders include generalized anxiety disorder, panic disorder, and a variety of phobias.

14.4.2 Explain how psychological theories account for anxiety disorders

The psychodynamic approach emphasizes the unconscious conflicts as the cause of disabling anxiety. The humanistic approach emphasizes the effects of a faulty self-image. The behaviorists emphasize the effects of previous learning, particularly avoidance learning. Cognitive theories of anxiety focus on distorted thinking and being fearful of others’ attention and judgements.

14.4.3 Name and briefly describe some important anxiety related disorders

The obsessive-compulsive and related disorders include obsessive-compulsive disorder and hoarding disorder. Trauma- and stressor-related disorders include adjustment disorder, acute stress disorder, and post-traumatic disorder. Dissociative disorders may take the form of amnesia, fugue, or multiple identities. Somatic symptoms and related disorders center on physical complaints that mimic disease or disability. Three examples are somatic symptom disorder, factitious disorder (Munchausen syndrome and Munchausen by proxy), and conversion disorder.

14.5 Psychology and Your Skill Set: Perseverance

14.5.1 Create a plan to improve your “grit” and perseverance

In psychology, “grit” refers to having the passion and perseverance to pursue a long-term goal, and is associated with four characteristics: interest, (deliberate) practice, purpose, and hope. Improving your level of grit requires that people engage in deliberate practice when you are pursuing a goal. Deliberate practice involves staying focused during training, seeking feed back from experts, and then working to correct problems that have been identified. Fostering a sense of hope will allow you to overcome the obstacles that inevitably occur when we are working toward important goals.