Unit XII & XIII
Unit XII & XIII: Abnormal Behavior and Treatment of Abnormal Behavior
Module 65: Introduction to Psychological Disorders
What is a Psychological Disorder?
Definition: A syndrome (group of symptoms)
Marked by clinically significant disturbance in:
Cognition (thinking)
Emotion regulation
Behavior
Causes:
Distress
Dysfunction (interferes with daily life)
Key Ideas:
Behavior must be:
Maladaptive (harmful or interfering with life)
Causes significant distress
Occasional sadness or fear = normal
When emotions become:
Persistent
Disabling
Interfere with work/relationships
→ May indicate a disorder
Culture & Normality
Definitions of “normal” change over time
Example: Homosexuality was classified as a disorder until 1973
Culture influences:
What is considered abnormal
How symptoms appear
Understanding Psychological Disorders
The Medical Model
Core Idea: Psychological disorders are mental illnesses with physical causes.
Causes include:
Brain abnormalities
Genetics
Biochemistry
Treatment options:
Therapy
Medication
Hospitalization (if severe)
Important Point: Mental disorders are treated like physical illnesses.
The Biopsychosocial Approach
Core Idea: Disorders result from the interaction of:
Biological factors:
Genes
Brain structure
Brain chemistry
Evolution
Psychological factors:
Stress
Trauma
Learned helplessness
Negative thinking patterns
Social-cultural factors:
Roles
Expectations
Cultural definitions of normality
Family & environment
Stress-Vulnerability Model (Diathesis-Stress Model)
Individuals possess genetic vulnerabilities.
Stressful experiences can trigger a disorder.
Risk depends on:
Biology + environment working together
Epigenetics
Definition: Study of how the environment affects gene expression
Genes can be:
Turned “on” or “off”
Environment influences whether a disorder develops.
Cultural Differences in Disorders
Some disorders appear worldwide:
Major depressive disorder
Schizophrenia
Culture-specific disorders include:
Susto (Latin America) – anxiety linked to fear
Taijin-kyofusho (Japan) – fear of offending others
Amok (Malaysia) – sudden violent outburst
Eating disorders are more common in Western cultures.
Module 66: Anxiety, OCD, PTSD
Anxiety Disorders
Definition: Psychological disorders marked by:
Excessive fear
Persistent anxiety
Avoidance behaviors
Anxiety interferes with daily life
Fear vs. Anxiety
Fear: Response to immediate threat
Anxiety: Worry about future threat
Types of Anxiety Disorders
Generalized Anxiety Disorder (GAD)
Key Features:
Persistent, uncontrollable worry
Worry lasts 6 months or more
Concern about everyday things (school, health, money)
Physical Symptoms:
Muscle tension
Restlessness
Fatigue
Difficulty concentrating
Sleep problems
Important: The person knows worry is excessive; feels unable to control it.
Panic Disorder
Panic Attacks: Sudden episodes of intense fear that peak within minutes
Symptoms Include:
Racing heart
Sweating
Trembling
Shortness of breath
Chest pain
Feelings of losing control
Fear of dying
Key Feature: Fear of having another panic attack.
Phobias
Definition: Persistent, irrational fear of specific object or situation
Examples:
Heights
Flying
Spiders
Public speaking
Important: The person recognizes fear is unreasonable; avoids the trigger; interferes with daily life.
OCD (Obsessive-Compulsive Disorder)
Obsessions:
Recurrent, intrusive thoughts that cause anxiety or distress
Examples:
Fear of contamination
Doubts about locking doors
Aggressive or disturbing thoughts
Compulsions:
Repetitive behaviors done to reduce anxiety
Examples:
Excessive hand washing
Checking repeatedly
Counting or arranging objects
Key Points: Person knows behaviors are irrational but feels driven to perform them; temporary relief is followed by a cycle of compulsive behavior.
Post-Traumatic Stress Disorder (PTSD)
Caused by: Exposure to traumatic events such as:
War
Assault
Serious accidents
Natural disasters
Symptoms Include:
Flashbacks
Nightmares
Avoiding reminders of trauma
Hypervigilance
Emotional numbness
Irritability
Risk Factors:
Severity of trauma
Lack of support
Previous trauma
Biological sensitivity
Understanding Anxiety Disorders, OCD, and PTSD
Biological Perspective
Genetic vulnerability
Overactive amygdala
Neurotransmitter imbalances
Stress hormone dysregulation
Learning Perspective
Classical conditioning (learned fear)
Operant conditioning (avoidance reduces anxiety, which gets reinforced)
Cognitive Perspective
Catastrophic thinking
Overestimating danger
Hyperfocus on threat.
Module 67: Depressive Disorders, Bipolar Disorder, Suicide, and Self-Injury
Major Depressive Disorder (MDD)
Definition: A mood disorder marked by persistent feelings of sadness and loss of interest.
Diagnosis: Symptoms must last at least 2 weeks and cause distress or impairment.
Core Symptoms Include:
Depressed mood most of the day
Loss of interest or pleasure (anhedonia)
Changes in sleep (too much or too little)
Changes in appetite/weight
Fatigue or loss of energy
Feelings of worthlessness or guilt
Trouble concentrating
Thoughts of death or suicide
Depression Facts
More common in women than men
Often begins in adolescence or early adulthood
Recurrence is common (once experienced, the risk increases)
Rates vary across countries
Bipolar Disorder
Definition: Mood disorder with alternating episodes of depression and mania.
Mania Symptoms:
Elevated or euphoric mood
Little need for sleep
Inflated self-esteem/grandiosity
Rapid speech
Racing thoughts
Impulsive or risky behavior
Key Points: Can cause serious problems (e.g., spending sprees, unsafe behavior); often followed by a depressive crash.
Types:
Bipolar I → full manic episodes
Bipolar II → hypomania (less severe mania) + depression
Key Difference: Major Depression = no mania; Bipolar Disorder = includes mania.
Depression Worldwide
Occurs in many cultures
Poverty increases risk
Stressful life events increase risk
Often underdiagnosed in some countries
Biological Perspective of Depression
Genetics: Runs in families; higher risk if close relative has depression
Brain & Neurotransmitters: Low levels of:
Serotonin
Norepinephrine
Differences in:
Frontal lobe activity
Stress hormone regulation
Overactive amygdala
Cognitive & Social-Cognitive Perspective
Negative Thinking Patterns:
Overgeneralization
Catastrophizing
Personalization
Self-blame
Learned Helplessness: Feeling no control over life events; giving up easily
Rumination: Repeatedly thinking about negative feelings
Vicious Cycle: Negative thoughts → bad mood → negative behavior → worse thoughts
Suicide
Key Facts:
One of leading causes of death in teens & young adults
Higher completion rates in men, higher attempt rates in women
Strongly linked to depression
Risk Factors:
Previous suicide attempt
Hopelessness
Substance abuse
Social isolation
Major life stress
Access to lethal means
Warning Signs:
Talking about death
Giving away belongings
Sudden calmness after depression
Withdrawing from others
Drastic mood changes
Non-Suicidal Self-Injury (NSSI)
Definition: Deliberate self-harm without intent to die
Purpose:
Release emotional pain
Regain sense of control
Feel something instead of numbness
More common in: Adolescents
Module 68: Schizophrenia
What is Schizophrenia?
Definition: A psychotic disorder characterized by:
Delusions
Hallucinations
Disorganized speech
Disorganized or catatonic behavior
Diminished emotional expression
Psychotic Disorder:
Loss of contact with reality; distorted perceptions and beliefs
Symptoms of Schizophrenia
Symptoms are divided into:
Positive Symptoms (presence of abnormal behaviors):
Hallucinations: False sensory experiences (most common: hearing voices)
Delusions: False beliefs
Persecution (“people are spying on me”)
Grandeur (“I have special powers”)
Disorganized Speech: Incoherent or illogical speech (often referred to as “word salad”)
Disorganized Behavior: Childlike silliness, agitation, catatonia (immobile or rigid body)
Negative Symptoms (absence of normal behaviors):
Flat affect (little emotional expression)
Reduced speech (alogia)
Loss of motivation (avolition)
Social withdrawal
Impaired attention
Brain Structure and Activity
Brain Structure:
Enlarged ventricles (fluid-filled spaces)
Loss of brain tissue
Reduced frontal lobe activity
Abnormal prefrontal cortex functioning
Brain Activity:
Overactive dopamine system
Too many dopamine receptors
Dopamine Hypothesis: Schizophrenia linked to excess dopamine activity; antipsychotic medications reduce dopamine.
Prenatal and Environmental Risk Factors
Prenatal Influences:
Maternal viral infections
Malnutrition during pregnancy
Oxygen deprivation at birth
Environmental Triggers:
Severe stress
Drug use (especially marijuana)
Urban upbringing
Social isolation
Genetic Factors
Genetic Influence:
Runs in families; risk increases with biological relatives
Risk Rates:
General population: ~1%
Identical twin with schizophrenia: ~48%
Important Consideration
Genes increase vulnerability; the environment influences whether a disorder develops, following the vulnerability-stress model.
Nature + Nurture
aA
Schizophrenia results from:
Genetic predisposition
Brain abnormalities
Prenatal factors
Stressful life experiences
Module 69: Other Disorders
Somatic Symptom & Related Disorders
Somatic Symptom Disorder:
Physical symptoms with no clear medical cause
Person is genuinely distressed; symptoms are not “faked”
Psychological factors influence physical symptoms
Conversion Disorder:
Neurological symptoms (paralysis, blindness, seizures) with no medical explanation; often triggered by stress; not consciously pretending.
Illness Anxiety Disorder:
Previously called hypochondriasis; fears of having a serious illness and misinterpreting normal body sensations. Anxiety continues despite medical reassurance.
Dissociative Disorders
Definition: Disorders involving disruptions in:
Memory
Identity
Consciousness
Dissociative Identity Disorder (DID):
Formerly called Multiple Personality Disorder; characterized by two or more distinct identities and memory gaps between identities; often linked to severe childhood trauma.
Controversy Around DID
Some believe: It is a real trauma response
Others argue: It may be therapist-induced or cultural influence may play a role.
Personality Disorders
Definition: Inflexible, enduring behavior patterns that impair social functioning, beginning by adolescence or early adulthood.
Three Clusters of Personality Disorders
Cluster A (Odd/Eccentric):
Paranoid
Schizoid
Schizotypal
Cluster B (Dramatic/Emotional/Impulsive):
Antisocial
Borderline
Histrionic
Narcissistic
Cluster C (Anxious/Fearful):
Avoidant
Dependent
Obsessive-Compulsive Personality Disorder
Antisocial Personality Disorder
Key Traits:
Lack of conscience
Disregard for others’ rights
Often lies, fights, steals
Impulsive behavior; may begin with conduct disorder in childhood
Important Notes: Not all criminals have antisocial personality disorder; many show low emotional intelligence; reduced brain activity in frontal lobes; low physiological arousal (less fear response).
Eating Disorders
Anorexia Nervosa:
Refusal to maintain normal body weight, intense fear of gaining weight, distorted body image; most common in adolescent females; can be life-threatening.
Bulimia Nervosa:
Binge eating followed by purging (vomiting, laxatives, excessive exercise); weight often within normal range.
Risk Factors
Cultural pressure for thinness
Low self-esteem
Perfectionism
Family dynamics
Genetic influence
Unit XIII: Treatment of Abnormal Behavior
Module 70: Introduction to Therapy, Psychodynamic and Humanistic Therapies
Treating Psychological Disorders
Two Main Approaches:
Psychotherapy:
Treatment through talking.
Client works with a trained therapist.
Aims to change thoughts, emotions, behaviors.
Biomedical Therapy:
Uses medications or medical procedures.
Affects brain functioning directly.
Psychoanalysis
Founded by: Sigmund Freud
Goal: Bring unconscious conflicts into conscious awareness.
Key Assumptions:
Psychological problems come from childhood conflicts.
Repressed memories influence behavior.
Techniques of Psychoanalysis
Free association (say whatever comes to mind)
Dream analysis
Resistance (blocking painful thoughts)
Transference (client projects feelings onto therapist)
Psychodynamic Therapy
Modern version of psychoanalysis.
Less intense; focuses on:
Current relationships
Unconscious patterns
Childhood experiences
Shorter and more practical than Freud’s method.
Humanistic Therapy
Focus: Growth potential, self-awareness, self-acceptance.
Client-Centered Therapy (Carl Rogers):
Key Ideas:
Unconditional positive regard
Active listening
Empathy
Nonjudgmental environment
Goal: Help clients accept themselves and encourage personal growth.
Module 71: Behavior, Cognitive & Group Therapies
Behavior Therapies
Core Idea: Maladaptive behaviors are learned; therefore, they can be unlearned.
Classical Conditioning Techniques
Systematic Desensitization: Gradual exposure to feared object using relaxation techniques.
Exposure Therapy: Direct exposure to fear, helping reduce anxiety over time.
Aversive Conditioning: Pair unwanted behavior with an unpleasant stimulus.
Operant Conditioning Techniques
Token Economy: Reward desired behaviors with tokens that can be exchanged for privileges.
Cognitive Therapies
Core Idea: Thoughts influence feelings and behavior; change thinking → change emotions.
Cognitive Therapy (Aaron Beck):
Identify negative automatic thoughts.
Challenge irrational beliefs.
Replace with realistic thinking.
Rational-Emotive Behavior Therapy (Albert Ellis):
Confront irrational beliefs directly.
Change self-defeating thoughts.
Cognitive-Behavioral Therapy (CBT):
Combines cognitive therapy and behavior therapy.
Most widely used therapy today.
Effective for depression, anxiety, OCD, PTSD.
Group & Family Therapies
Group Therapy:
Small group sessions; benefits include support, shared experiences, feedback, and lower cost.
Family Therapy:
Treats family as a system; improves communication; resolves conflicts.
Self-Help Groups:
Example: Alcoholics Anonymous (AA); provide peer support and follow a 12-step program.
Module 72: Evaluating Psychotherapies
Does Psychotherapy Work? How Can We Know?
Client Testimonials:
Clients and therapists often report improvement, but improvement could be due to:
Regression toward the mean
Placebo effect
Natural life changes
Clients wanting to justify time/money spent
Personal stories alone cannot prove therapy works.
Outcome Research
Meta-Analysis: Combines results of hundreds of therapy studies; compares treated vs. untreated groups.
Findings:
People receiving psychotherapy improve.
Those in therapy improve faster than those without treatment.
Therapy reduces relapse rates.
Conclusion: Psychotherapy is effective.
Are Some Psychotherapies More Effective for Specific Disorders?
No one therapy is superior for all disorders; some work better for specific problems:
Behavior conditioning → phobias
CBT → depression, anxiety
Psychodynamic → relationship issues
PTSD often treated with trauma-focused therapies.
Effective for Clear, Specific Problems:
EMDR (Eye Movement Desensitization and Reprocessing):
Used mainly for PTSD; client recalls traumatic memory while following therapist’s finger movements.
Research suggests EMDR helps PTSD, but benefits may not come solely from eye movements; likely works through exposure to trauma memory.
Light Exposure Therapy:
Used for Seasonal Affective Disorder (SAD).
Bright light exposure improves mood by affecting brain regions controlling arousal and hormone regulation.
What Three Elements Are Shared by All Forms of Psychotherapy?
All psychotherapies provide:
Hope
A new perspective
An empathetic, trusting, caring relationship
Therapeutic Alliance: The emotional bond between therapist and client; one of the strongest predictors of improvement.
Culture and Values in Psychotherapy
Therapy must consider:
Cultural background
Religious beliefs
Language
Family values
Attitudes toward mental health
People often feel more understood when:
Therapist shares or respects their cultural values; cultural sensitivity improves trust, communication, and treatment success.
Finding a Mental Health Professional
Warning Signs That Someone Should Seek Help:
Feelings of hopelessness
Deep and lasting depression
Self-destructive behavior (substance abuse)
Disruptive fears
Sudden mood shifts
Suicidal thoughts
Compulsive rituals
Hearing voices or seeing things others don’t
Types of Mental Health Professionals
Clinical Psychologists:
PhD or PsyD; provide psychotherapy; research training
Psychiatrists:
Medical doctors (MD); can prescribe medication
Clinical Social Workers:
Master’s degree; provide therapy for everyday/family problems
Counselors:
Often specialize (marriage, substance abuse, etc.)
Module 73: The Biomedical Therapies and Preventing Psychological Disorders
The Biomedical Therapies
Definition
Biomedical therapies are treatments that:
Change the brain’s chemistry
Alter brain activity
Target biological causes of psychological disorders
Assumption: Mind and body are connected; changing one affects