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THE SCOPE AND NATURE OF PSYCHOLOGICAL DISORDERS

• Psychological disorders significantly impact individual and societal well-being.

• Statistics reveal:

  • 1 in 5 Canadians experience a mental health problem at any point in time.

  • Nearly half of North Americans aged 15-54 will experience a psychological disorder in their lifetime.

  • Psychological disorders are the second leading cause of disability, surpassing physical illnesses and accidents.

  • Medications for anxiety and depression are among the most frequently prescribed in North America.

  • 1 adolescent dies by suicide every 90 seconds in North America, with 90% diagnosed with a mental disorder.

  • 24% of deaths among 15- to 24-year-olds are due to suicide.

  • Over a million students withdraw from universities each year due to emotional problems.

  • 1 in 4 North Americans will have a substance abuse disorder in their lifetime.

  • North American businesses lose over $120 billion annually due to psychological disorders.

  • Psychological disorders account for over 15% of the financial burden of illness in developed economies.

DEFINING “ABNORMAL”

• Determining normal vs. abnormal behavior is complex, influenced by:

  1. Personal values of diagnosticians

  2. Cultural expectations

  3. General assumptions about human nature

  4. Statistical deviation

  5. Distress, dysfunction, and deviance

• Criteria for abnormality often includes:

  • Distress: Intense emotional suffering.

    • Personal distress is an essential marker but not solely definitive of abnormality.

  • Dysfunction: Impaired functioning in daily life.

    • Maladaptive behaviors affecting personal relationships or societal norms.

  • Deviance: Behaviors that violate societal norms or expectations.

    • Cultural context can drastically influence how behaviors are classified as normal or abnormal (e.g., cannibalism historically accepted in certain societies).

JUDGING ABNORMALITY

• The three D’s of abnormal behavior:

  1. Distress: Intense distress often labels behavior as abnormal.

  2. Dysfunction: Dysfunctional behaviors influence work and social relationships.

  3. Deviance: Societal norms dictate what is considered deviant behavior.

• Abnormal behavior is characterized as:

  • Personally distressing

  • Dysfunctional in daily life

  • Deviant, violating cultural norms.

DSM-5 CATEGORIES

• Over 300 disorders classified in DSM-5, including:

  • Anxiety Disorders: Intense anxiety that may not be reality-bound (e.g., phobias, panic disorders).

  • Mood Disorders: Severe mood swings, including depression and mania.

  • Somatic Symptom Disorders: Physical symptoms without a physical cause.

  • Dissociative Disorders: Problems of consciousness including amnesia and identity dissociation.

  • Psychotic Disorders: Loss of reality contact (e.g., schizophrenia).

  • Eating Disorders: Such as anorexia and bulimia.

  • Personality Disorders: Rigid patterns of thinking and behavior, often social deviance.

HISTORICAL PERSPECTIVES ON DEVIANT BEHAVIOR

• Historical narratives reveal that psychological disorders have existed across civilization, with examples such as:

  • Biblical characters (e.g., King Saul) showing symptoms of emotional instability.

  • Famous figures like Mozart, Lincoln, and Churchill suffering from psychological disorders impacting their lives.

  • Treatment methods have evolved over time, moving from supernatural explanations to biological understandings (Hippocrates).

• Supernatural beliefs (e.g., demonology) were prominent until the late 19th and 20th centuries.

VULNERABILITY-STRESS MODEL

• Personality and biological vulnerabilities intersecting with environmental stressors contribute to psychological disorders.

• Vulnerabilities include:

  • Genetic predispositions affecting neurotransmitter systems.

  • Psychological predispositions such as low self-esteem and pessimism.

  • Environmental events such as trauma or abuse.

DIAGNOSING PSYCHOLOGICAL DISORDERS

• Diagnostic classification systems must demonstrate:

  • Reliability: High agreement among clinicians.

  • Validity: Accurate definitions and categories for different psychological disorders.

• DSM-5 incorporates both categorical and dimensional approaches.

SOCIAL AND PERSONAL IMPLICATIONS OF DIAGNOSIS

• Labels can carry significant personal and social ramifications, affecting self-perception and interactions with others.

• Research shows that outward perceptions of patients can shift dramatically upon the labeling of psychological disorders.

SUICIDE PREVENTION

• Steps to assist those considering suicide involve:

  • Directly discussing suicidal thoughts to initiate support.

  • Encouraging the individual to express feelings and stresses.

  • Providing information about professional resources.

ANXIETY DISORDERS

• Four components of anxiety:

  • Subjective-emotional feelings (tension/apprehension).

  • Cognitive processes (anticipation of threat).

  • Physiological responses (increased heart rate, sweating).

  • Behavioral responses (avoidance/impairment).

• Common forms include phobia disorders, generalized anxiety disorder (GAD), and panic disorders.

EATING DISORDERS

• Anorexia nervosa characterized by:

  • Intense fear of weight gain.

  • Extreme food restriction leading to significant health risks.

• Bulimia nervosa characterized by:

  • Binge-eating followed by purging (vomiting/laxatives).

• Biological, psychological, and social factors all interact in the etiology of eating disorders.

MOOD DISORDERS

• Key components of mood disorders include:

  • Emotional (sadness/loss), cognitive (negative thoughts), motivational (low initiation), and somatic (physical changes).

• Bipolar disorders involve fluctuations between manic and depressive states.

DISSOCIATIVE DISORDERS

• Major types include:

  • Dissociative Amnesia: Loss of memory, usually after trauma.

  • Dissociative Fugue: Loss of personal identity and wandering.

  • Dissociative Identity Disorder: Presence of two or more distinct identities.

• Theories include trauma-dissociation theory, positing DID arises as a defense mechanism to trauma.

SCHIZOPHRENIA

• Features include disruptions in thought, emotion, and perception.

  • Characterized by hallucinations, delusions, and disorganized speech.

• Positive symptoms represent an excess or distortion of normal functions, while negative symptoms represent a loss of normal capabilities.

PERSONALITY DISORDERS

• Involve rigid patterns leading to significant dysfunction in personal and social contexts.

• Specific disorders include Antisocial Personality Disorder and Borderline Personality Disorder, both with diverse biological and environmental underpinnings.