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Unit 5: Mental and Physical Health 

Topic 5.4: Selection of Categories of Psychological Disorders Teacher: Kadi Alteini 

What Are Neurodevelopmental Disorders? 

− These are a group of psychological conditions that affect how the brain develops,  especially during early childhood. They influence: Thinking, Learning, Social behavior  and Self-regulation (impulse control). 

• Neurodevelopmental disorders begin (onset) during the developmental period  (usually before adulthood). 

• Symptoms focus on whether the person shows behaviors appropriate for their age  or maturity level. 

• The two disorders in scope for AP Psychology: Attention-Deficit/Hyperactivity  Disorder (ADHD) and Autism Spectrum Disorder (ASD). 

• Causes may be genetic, physiological, or environmental. 

1. Attention-Deficit/Hyperactivity Disorder (ADHD) 

• Symptoms of ADHD symptoms fall into 3 categories: 

A. Inattention: 

• Difficulty focusing on tasks 

• Frequently losing things 

• Easily distracted 

• Forgetful with daily activities (homework, chores) 

B. Hyperactivity: 

• Constant movement (can’t sit still) 

• Fidgeting, tapping 

• Talking excessively 

C. Impulsivity: 

• Interrupting conversations 

• Acting without thinking 

• Trouble waiting their turn 

− Diagnosis Criteria (According to DSM-5): 

• Symptoms must last at least 6 months 

• Must appear before age 12 

− Possible Causes of ADHD: 

• Physiological: 

o Low dopamine activity  

o Differences in brain regions linked to impulse control and focus 

• Environmental: 

o Exposure to toxins like lead or prenatal alcohol exposure 

o Low birth weight or premature birth 

• Genetic: 

o Strong hereditary component (runs in families) 

2. Autism Spectrum Disorder (ASD) 

− Why Is It a “Spectrum”? The word "spectrum" doesn’t mean “mild to severe.” It means  people show different combinations of symptoms, and the intensity of each varies  widely. 

− Main Symptoms of ASD:  

A. Social (Interpersonal) Communication Deficits:

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• Difficulty with back-and-forth conversations 

• Trouble understanding facial expressions or tone 

• Little or no eye contact 

• Struggles to show empathy for others 

B. Stereotyped or Repetitive Behaviors: 

• Repeating movements or phrases 

• Strong preference for routines 

• Intense focus on specific interests 

C. Sensory Sensitivities: 

• Overreaction or underreaction to light, sound, textures, or smells 

− Diagnosis Criteria (According to DSM-5): 

• Symptoms must begin early in developmental period 

• Must not be better explained by other developmental delays 

− Possible Causes of ASD: 

• Physiological: 

o Differences in current brain connectivity 

o Atypical neural development (how the brain was formed) in early childhood • Environmental: 

o Parental age, exposure to toxins during pregnancy, or certain infections • Genetic: 

o ASD runs in families; certain gene mutations are associated with it 

What Are Schizophrenic Spectrum Disorders? 

− Schizophrenic spectrum disorders are chronic (ongoing) or acute (sudden episodes)  psychological disorders that impact a person’s thinking, perception, emotions,  movement, and ability to relate to others. 

• Acute: Symptoms begin (onset) suddenly, often after a stressful life event. Typically  responds better to treatment. 

o Example: A college student suddenly experiences hallucinations during exam  stress. 

• Chronic: Develops gradually and worsens over  

− Symptoms fall into five major areas, and can be categorized as positive (something  abnormal added) or negative (something normal missing). 

• Schizophrenia symptoms vary greatly between individuals. Some may have mostly  positive symptoms, others negative, and some both. It's called a “spectrum” not  because it varies in severity, but because it involves a range of different symptom  profiles. 

• Mnemonic to Remember the 5 Symptom Areas:  

1. Delusions 

2. Hallucinations 

3. Disorganized thinking or speech 

4. Disorganized motor behavior 

5. Negative symptoms 

− Disorganized Motor Behavior: Inappropriate physical movements which may manifest  as catatonia which includes two forms as a positive symptom (catatonic excitement) or  negative symptom (catatonic stupor). 

• Catatonic Excitement (Positive Symptom): Excessive and purposeless movement  (e.g., pacing, flailing). 

o Example: Pacing back and forth, flailing arms without purpose.

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• Catatonic Stupor (Negative Symptom): Lack of movement, speech or response. o Example: A person stays in one frozen position for hours, not reacting. − Positive Symptoms: present as something abnormal added. 

A. Delusions (false beliefs): are false beliefs held with strong conviction despite evidence  to the contrary. They can manifest in ways such as delusions of persecution or grandeur. • Delusions of Persecution: Believing someone is out to harm you or plotting against  you. 

o Example: A person thinks their neighbors are secretly government agents  spying on them through the TV. 

• Delusions of Grandeur: Believing you are someone incredibly important or powerful  or have special powers. 

o Example: Believing you are a reincarnation of a historical figure or that you  control the weather. 

B. Hallucinations (false perceptions): are false sensory experiences where the brain  perceives something that isn’t really there and may involve one or more of the senses.  Most common are auditory and visual hallucinations. 

• Auditory Hallucinations: Hearing voices or sounds. 

o Example: Hearing voices telling you you’re being watched. 

• Visual Hallucinations: Seeing things that aren’t present. 

o Example: Seeing people or shadows that others don’t see. 

• Others include tactile (touch), olfactory(smell) and gustatory (taste), though these  are less common. 

C. Disorganized Thinking or Speech: incoherent thoughts leads to jumbled or illogical speech that is hard to follow. It may manifest in ways such as speaking in a word salad. • Word Salad: Random words thrown together that don’t make sense. o Example: “The toaster flies high because purple eats honesty.” 

• Can also include jumping from one topic to another with no connection. o Example: “I went to the store... clouds are fluffy... did you see my shoes?” D. Catatonic Excitement 

− Negative Symptoms: present as the lack of a normal behavior. 

A. Flat Affect: lack of emotional expression. 

• Example: A person talks in a monotone voice and doesn’t smile or frown, even  during emotional moments. 

B. Catatonic Stupor 

− Diagnosis Criteria 

• At least two of the five symptoms must be present for one month. 

• At least one must be: delusions, hallucinations, or disorganized speech. − Possible Causes of Schizophrenic Spectrum Disorders 

• There’s no single cause, but research points to a combination of genetic, biological,  and environmental factors. 

• Biological Factors 

o Dopamine Hypothesis: People with schizophrenia may have too much dopamine  activity in key brain areas. This helps explain positive symptoms like hallucinations  and delusions. 

o Prenatal Risk Factors - Viral Infections: Exposure to viruses during pregnancy may  increase risk. 

• Genetic predisposition: 

o Schizophrenia runs in families. The more closely related someone is to a person  with schizophrenia, the higher their risk.

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o Example: Identical twins have a higher chance than fraternal twins. o Certain gene mutations have been linked to the disorder. 

o No single “schizophrenia gene,” but a complex interaction of genes. • Environmental Stressors: High stress can trigger schizophrenia in genetically  vulnerable individuals. 

o Examples: Childhood trauma, social isolation, major life changes. 

What are Depressive Disorders? 

− Depressive disorders are characterized by a persistent sad, empty, or irritable mood  along with cognitive (thinking-related) and physical changes. These changes affect how  a person functions in everyday life such as at work, school, relationships, or self-care. 

− The two disorders in scope for AP Psychology: Major Depressive Disorder (MDD) and  Persistent Depressive Disorder (PDD). 

1. Major Depressive Disorder (MDD) 

− Symptoms (must last at least 2 weeks):  

− The symptoms appear in three major areas: 

• Emotional: 

o Deep sadness, hopelessness, worthlessness 

o Feeling empty, tearful, or irritable 

o Example: A person may cry daily without knowing why or say things like,  "Nothing matters anymore." 

• Cognitive: 

o Trouble concentrating or making decisions 

o Suicidal thoughts or preoccupation with death 

o Example: Someone may stare at a homework question for hours but feel unable  to think clearly enough to answer. 

• Physical: 

o Fatigue, sleep problems (too much or too little), changes in appetite, weight  loss/gain 

o Example: Someone may sleep 14 hours a day but still feel exhausted. 2. Persistent Depressive Disorder (PDD) (also known as Dysthymia):  − A chronic, low-grade depression that lasts for at least 2 years.  

− Symptoms: Milder than MDD but more persistent 

• Emotional: chronic low mood, feeling "meh" or emotionally numb • Cognitive: low self-esteem, difficulty concentrating 

• Physical: constant fatigue, sleep/eating irregularities 

• Example: A person goes to school every day, smiles at jokes, but deep down feels  emotionally disconnected and tired like they’re running on empty but no one  notices. 

− Possible Causes of Depressive Disorders: 

• Biological: 

o Neurotransmitter imbalances: Low serotonin, dopamine, norepinephrine levels  are linked to low mood, loss of pleasure and low energy. 

o Brain structure differences: Reduced activity in the prefrontal cortex can impact  decision-making and emotion regulation. 

o Genetics: People with a family history of depression are more likely to develop  it. 

• Social & Cultural:

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o Long-term exposure to poverty, discrimination, or family conflict increase  vulnerability. 

o Cultural stigma: In some cultures, talking about mental health is taboo. This  prevents people from seeking help, worsening symptoms so individuals suffer in  silence. 

o Social isolation or lack of support: Loneliness and feeling disconnected from  others are risk factors. 

• Behavioral: 

o Learned helplessness: When people believe their actions don’t affect outcomes,  they stop trying. After repeated failures or uncontrollable situations, a person  may believe that nothing they do will change their circumstances. 

o Observational learning: Watching a parent or role model cope with stress  through negativity or hopelessness may lead to learned patterns of helplessness. • Cognitive: 

o Negative thinking patterns (cognitive distortions): People may develop  automatic, irrational thoughts such as “I’m a failure,” “Nobody cares about me,”  “Things will never improve.” 

o Rumination: Constantly replaying past mistakes or losses keeps the brain  focused on negativity and blocks healing. 

What are Bipolar Disorders? 

− Bipolar disorders are characterized by periods of mania and periods of depression. • These are not everyday ups and downs. The shifts are intense, disruptive, and can  severely affect a person’s life, relationships, and ability to function. 

• Bipolar cycling involves the individual alternating between: depressive episodes  (like MDD symptoms) and Manic or hypomanic episodes (depending on the type of  bipolar disorder) in alternating periods that can last various amounts of time.  

− The two disorders in scope for AP Psychology: Bipolar I Disorder and Bipolar II  Disorder. 

1. Bipolar I Disorder: 

− Manic Episode (Required for Diagnosis): 

• To be diagnosed with Bipolar I, an individual must experience at least one full  manic episode that lasts at least 1 week or requires hospitalization. 

• Mania Symptoms:  

o Elevated or irritable mood 

o Inflated self-esteem or grandiosity (“I’m the next Elon Musk!”) 

o Decreased need for sleep (e.g., sleeping 2 hours and feeling “great”) o Racing thoughts and rapid speech 

o Increased goal-directed activity (e.g., suddenly starting 4 new businesses) o Risky behavior (e.g., impulsive spending, unsafe sex, reckless driving) − Depressive Episode (Often Present but Not Required): 

• After the high, there’s usually a crash: sadness, low energy, hopelessness, and all the  symptoms of MDD 

2. Bipolar II Disorder 

− Hypomanic Episode:  

• Similar to mania but less extreme, noticeable by others but not severe enough to  require hospitalization or cause major impairment. 

o Elevated mood, increased productivity, but still functional 

o More social, confident, creative

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o Still risky, but not dangerous levels 

− Depressive Episode (Required): 

• Individuals with Bipolar II must experience at least one major depressive episode,  often spending more time in depression than hypomania. 

− Possible Causes of Bipolar Disorders: 

• Biological: 

o Neurotransmitter Imbalances: Irregular levels of serotonin, dopamine, and  norepinephrine disrupt mood regulation and are associated with mood swings  in bipolar disorder.  Example: Excess dopamine is linked to manic episodes  (euphoria, impulsivity); low serotonin is linked to depressive symptoms. 

o Brain Structure Differences: Differences in the prefrontal cortex (decision making and impulse control) and amygdala (emotion processing) may  contribute to symptoms. 

o Genetic: Strong hereditary link if a parent or sibling has bipolar disorder, risk  increases significantly. 

• Social & Cultural: 

o Stressful life events, trauma, and major transitions (e.g., moving away, job loss,  divorce) can trigger episodes in people who are biologically predisposed. o Cultural misinterpretation: In some cultures, symptoms of mania (e.g., elevated  mood, fast speech) may be misread as enthusiasm or spiritual experiences,  delaying proper diagnosis and treatment. 

• Behavioral: 

o Reinforcement of Risky Behavior: During manic phases, behaviors like  overspending or thrill-seeking may be positively reinforced (e.g., praised for  being "productive" or "fun"), which can unintentionally encourage future manic  episodes. 

o Individuals may learn to associate certain environments or routines with  emotional highs or lows, potentially influencing mood cycles. 

• Cognitive: 

o Cognitive Distortions: During depressive phases, individuals may experience  negative automatic thoughts, such as “I’m a failure” or “No one cares,” which  worsen their low mood. 

o Grandiose Thinking: In manic phases, individuals may have inflated self-esteem  or unrealistic beliefs (e.g., “I can become famous overnight”), contributing to  impulsive decisions. 

What Are Anxiety Disorders? 

− Anxiety is a natural response to stress or danger. But when it becomes excessive,  irrational, and interferes with daily life, it may be classified as an anxiety disorder. • Anxiety disorders are characterized by excessive fear and/or anxiety with related  disturbances to behavior. 

• The five disorders in this category in scope for AP Psychology: Specific Phobia, Agoraphobia, Panic Disorder, Social Anxiety Disorder and Generalized Anxiety  Disorder. 

− All anxiety disorders share these core characteristics: 

• Excessive fear or anxiety 

• Avoidance behaviors (trying to escape or prevent anxiety triggers) 1. Specific Phobia: An intense, irrational fear of a specific object or situation (e.g., spiders,  heights, flying). The fear is disproportionate to the actual danger.

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• Phobia Examples:  

o Arachnophobia, which is the fear of spiders. 

o Acrophobia, which is the fear of heights. 

• Example: Jenna avoids visiting her cousin’s house because they have a pet dog even  though the dog is harmless. Just seeing a dog from afar makes her heart race. − Causes: 

• Biological: 

o Genetic Predisposition: A family history may increase vulnerability. o Evolutionary Perspective: Some phobias (like fear of snakes or heights) may be  biologically prepared due to ancestral survival benefits. 

• Behavioral: 

o Classical Conditioning: A neutral stimulus (e.g., dog) becomes associated with  fear after a traumatic event (e.g., being bitten). Example: Bitten by a dog → pain  and fear → now dogs trigger fear. 

o Observational Learning: Fear is learned by watching others respond fearfully.  Example: You saw your older sibling scream around spiders → you learned  spiders are scary 

o Operant Conditioning: Avoiding the phobic object reduces anxiety, which  reinforces the behavior (negative reinforcement). Example: Avoiding elevators  lowers anxiety, so the person keeps avoiding them. 

• Maladaptive Emotional Responses or Cognitive Thinking: 

o Catastrophic or irrational thinking: “If I get on a plane, it will definitely crash.” o Hyper vigilance: The person becomes overly alert to threats, misinterpreting  harmless stimuli as dangerous. Example: A harmless dog is perceived as a  serious threat just by appearance. 

2. Agoraphobia: A fear of being in social situations where escape might be difficult or help  wouldn’t be available if something goes wrong.  

• It includes using public transportation, being in open spaces such as a parking lot,  being in enclosed spaces such as theaters or shops or elevators, standing in a line or  being in a crowd, or being outside of the home alone. 

• Why Is Agoraphobia Not Just a Phobia? Unlike specific phobias that focus on one  trigger (like spiders), agoraphobia involves multiple settings and is deeply  connected to fear of helplessness in public spaces. It often co-occurs with panic  disorder, but is still its own diagnosis. 

− Causes: 

• Biological: 

o Genetic Predisposition: A family history may increase vulnerability. o Overactive Amygdala or Autonomic Nervous System:  

• Behavioral: 

o Classical Conditioning: A panic attack or distressing event in a public place  becomes associated with that setting.  

o Operant Conditioning (Negative Reinforcement): Avoiding public places lowers  anxiety, which reinforces the avoidance. Example: Avoiding grocery stores  makes the person feel safe, so they continue avoiding them. 

• Maladaptive Emotional Responses or Cognitive Thinking: 

o Catastrophic or irrational thinking: The person believes something terrible will  happen in public, and that escape or help won’t be available. Example: “If I go to  the store, I’ll panic, collapse, and no one will help me.”

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o Hyper Awareness of Bodily Sensations: Minor physical sensations (like a racing  heart) are misinterpreted as signs of danger, increasing fear and avoidance. 3. Panic Disorder: Involves the experience of panic attacks, which are unanticipated and  overwhelming. 

• Panic disorder involves repeated panic attacks. 

o Panic attacks are sudden episodes of intense fear or discomfort that peak within  minutes. 

o They are unpredictable, which creates more anxiety about when the next one  will come this fear itself becomes disabling. 

o Example: Amina was walking to class when suddenly she felt like she was dying  her heart raced, she couldn’t breathe, and she thought she was having a heart  attack. At the hospital, doctors found nothing physically wrong. This happens  frequently. 

• Symptoms of a Panic Attack: 

o Heart racing 

o Chest pain or shortness of breath 

o Sweating, trembling 

o Feeling like you're choking or dying 

o Derealization (feeling like things aren’t real) 

• Cultural views can influence how symptoms are expressed or understood o It can manifest as a culture-bound anxiety disorder such as ataque de nervios  experiences mainly by people of Caribbean or Iberian Descent. 

o Ataque de nervios (Caribbean/Iberian descent): intense emotional outbursts,  crying, trembling, shouting similar to panic attack but includes aggression or  dissociation and is triggered by family conflict. 

− Causes: 

• Biological: 

o Overactive Amygdala: The amygdala, responsible for fear processing, may be  hyperactive, triggering intense fight-or-flight responses unnecessarily. o Autonomic Nervous System Dysregulation: Some individuals have a biological  tendency for exaggerated physical responses to stress (e.g., racing heart,  hyperventilation). 

o Genetic Predisposition: A family history may increase vulnerability. • Behavioral: 

o Classical Conditioning: A panic attack in a certain place or situation can lead to a  learned association between that setting and fear. Example: A person  experiences a panic attack while driving and later becomes anxious every time  they drive. 

o Operant Conditioning (Negative Reinforcement): Avoiding locations where  panic attacks have occurred reduces anxiety, reinforcing the avoidance.  Example: If someone avoids crowded places because they had an attack in one,  the relief they feel makes the avoidance behavior stronger. 

• Maladaptive Emotional Responses or Cognitive Thinking: 

o Catastrophic Misinterpretation: The person misreads harmless physical  sensations (like a fast heartbeat) as signs of something deadly. Example: “My  chest is tight, I must be having a heart attack.” 

o Anticipatory Anxiety: Fear of having another panic attack leads to constant  worry and heightened sensitivity to bodily cues, which can actually trigger  another attack.

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4. Social Anxiety Disorder: Intense fear of being judged, watched, embarrassed, or  humiliated but others in social or performance situations. 

• Common triggers: Public speaking, Eating in public, Meeting new people , Using  public restrooms, presentations, performances. 

• Example: Faisal avoids all group presentations and dreads any interaction with his  classmates. He replays every social interaction in his head afterward, worrying he  sounded weird. 

• Cultural views can influence how symptoms are expressed or understood o It can manifest as a culture-bound anxiety disorder such as Taijin Kyofusho  experienced mainly by Japanese people in which people fear they are offending  others with their appearance or body such as how they smell. 

− Causes: 

• Biological: 

o Genetic Predisposition: A family history may increase vulnerability. o Hyperactive Amygdala: Individuals with social anxiety often show heightened  amygdala activation in response to perceived social threats (e.g., critical faces or  attention). 

• Behavioral: 

o Classical Conditioning: A person may associate social situations with  embarrassment or failure due to a past negative experience. Example: If  someone was laughed at while giving a presentation, they might begin to fear all  public speaking situations. 

o Operant Conditioning (Negative Reinforcement): Avoiding social situations  reduces anxiety, which reinforces avoidance behavior. Example: Skipping a  group activity reduces stress in the moment, making future avoidance more  likely. 

o Observational Learning: Witnessing others being judged or humiliated can lead  to internalizing social fears. Example: A child who sees a peer get mocked for  stuttering may develop a fear of speaking in class. 

• Maladaptive Emotional Responses or Cognitive Thinking: 

o Negative Self-Evaluation: Individuals often believe they will embarrass  themselves or be judged harshly. Example: “If I say something wrong, everyone  will think I’m stupid.” 

o Anticipatory and Post-Event Rumination: Excessive worry before a social  interaction and replaying it afterward to search for flaws. 

5. Generalized Anxiety Disorder (GAD): Prolonged experience of nonspecific anxiety or  fear. 

• Persistent and excessive worry about a wide range of topics, even when there’s little  or no reason to worry. It lasts at least 6 months and feels uncontrollable. • Accompanied by physical tension such as muscle aches, fatigue, difficulty sleeping  and trouble concentrating or feeling “on edge” 

• Example: Sarah worries constantly about school, friends, her future even when  things are going well. She can’t relax, always feels tense, and has trouble sleeping. − Causes: 

• Biological: 

o Low GABA Activity: GABA is a calming neurotransmitter. Low levels may fail to  “turn off” excessive neural activity, leading to constant anxiety. 

o Overactive Autonomic Nervous System: The body may stay in a heightened state  of arousal (e.g., tension, restlessness), even without a clear threat.

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o Genetic Predisposition: A family history may increase vulnerability. • Behavioral: 

o Avoidance Behavior: Individuals may avoid situations that cause even mild  stress, which prevents them from learning they can cope, reinforcing a sense of  helplessness. Example: Avoiding giving presentations at school means never  learning it’s manageable, so the fear continues to grow. 

o Lack of Reinforcement for Success: If someone repeatedly avoids challenges and  never receives positive feedback for facing them, their confidence remains low,  maintaining anxiety. 

• Maladaptive Emotional Responses or Cognitive Thinking: 

o Catastrophic Thinking: Persistent "what if" thoughts and imagining worst-case  scenarios about everyday events. Example: “What if I fail this test and ruin my  future?” 

o Cognitive Distortions: Overgeneralization, mind reading, or assuming disaster  are common in GAD. Example: “Everyone will think I’m a failure,” even when  there’s no evidence. 

o Intolerance of Uncertainty: People with GAD often feel distressed when things  are uncertain, leading them to overanalyze or obsess about possible outcomes. 

What are Obsessive-Compulsive and Related Disorders? 

− These disorders were once categorized under anxiety disorders, but the DSM-5  reclassified them into a separate category due to their distinct patterns of intrusive  thoughts (obsessions) and repetitive behaviors (compulsions). 

• However, anxiety remains a central feature, especially in how obsessions and  compulsions interact. 

• This category is defined by: 

o Obsessions: Unwanted, intrusive thoughts, urges, or mental images that cause  significant distress or anxiety. 

o Compulsions: Repetitive behaviors or mental acts performed to reduce the  anxiety triggered by the obsessions. 

• The two disorders in this category in scope for AP Psychology: Obsessive Compulsive Disorder (OCD) and Hoarding Disorder. 

A. Obsessive-Compulsive Disorder (OCD): 

• Core features: A pattern of obsessions and compulsions. 

o Cycle of OCD: Obsession → Anxiety → Compulsion → Temporary Relief → Obsession returns → Repeat 

o Negative Reinforcement explains the compulsive behavior: The compulsive act  removes anxiety, which makes the person more likely to repeat the behavior  next time. 

o Example: Leena can’t stop thinking about germs on her hands (obsession). To  ease her anxiety, she washes her hands 30 times before leaving the bathroom  (compulsion). If she doesn’t, she freaks out and feels something terrible will  happen. 

• Examples of Common Obsessions: 

o Fear of contamination (germs, dirt, illness) 

o Fear of causing harm to oneself or loved ones or making a mistake o Need for symmetry or exactness 

o Disturbing intrusive thoughts (e.g., violent or sexual or taboo thoughts) • Examples of Common Compulsions:

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o Excessive handwashing or cleaning 

o Rechecking things (e.g. appliance, stove, locks) 

o Counting, tapping, or ordering things in specific ways 

o Repeating phrases, prayers or actions 

B. Hoarding Disorder:  

• A disorder characterized by extreme difficulty discarding possessions, regardless of  their actual value, leading to clutter that interferes with daily life.  

o The obsessive fear is often about needing the item in the future or emotional  attachment to the object, and the compulsive behavior is the inability to discard  items to relieve the anxiety. 

o Example: Ali’s apartment is filled with stacks of old magazines, broken  appliances, and bags of receipts. He insists he’ll need them one day and feels  panicked at the thought of throwing anything away. 

• How hoarding fits the category: 

o Obsessive thoughts: “I might need this.” “Throwing this out is a mistake.” o Compulsive behavior: Avoidance of discarding items to prevent distress. • Symptoms of Hoarding Disorder: 

o Persistent difficulty discarding possessions, regardless of actual value o Distress or anxiety at the thought of throwing things away 

o Living spaces become cluttered or unusable (e.g., can’t use the kitchen, bed, or  bathroom normally) 

− Causes of OCD and Related Disorders 

• Biological Causes: 

o Overactivity in certain areas of the brain, which detects errors and threats and  habit formation. 

o Neurotransmitter Imbalance: Low levels of serotonin, which regulates mood and  impulse control, may contribute to OCD and hoarding behaviors. 

o Genetic Predisposition: OCD tends to run in families 

• Cognitive Causes - Maladaptive Thinking and Emotional Responses: o Intrusive Thoughts & Catastrophic Thinking: Belief that not performing a ritual  will cause harm. Example: “If I don’t tap the door three times, something bad  will happen to my family.” 

o Overestimation of Threat or Responsibility: Feeling personally responsible for  preventing disaster. Example: “It’s my fault if the house burns down because I  didn’t check the stove five times.” 

• Behavioral Causes: 

o Classical Conditioning: Neutral objects or thoughts become associated with  anxiety (e.g., door handle = danger after a contamination scare). 

o Operant Conditioning: Compulsions are reinforced because they reduce anxiety  (negative reinforcement). Example: compulsions or hoarding behaviors reduce  anxiety → behavior is repeated. 

o Observational Learning: Learning compulsive behaviors by watching others  (e.g., parent who obsessively cleans or keeps items). 

What Are Dissociative Disorders? 

− Dissociate Disorders are characterized by dissociations from consciousness, memory,  identity, emotion, perception, body representation, motor control and behavioral.  − Key Features of Dissociative Disorders: 

• Loss of memory (amnesia)

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• Disruption in identity 

• Feeling detached from reality, body, or emotions 

• Behaviors that seem disconnected from the self 

− Causes: The experience of trauma such as physical/sexual/emotional abuse or natural  disaster or war or personal loss or stress. 

− The two disorders in this category in scope for AP Psychology: Dissociative Amnesia  (with and without fugue) and Dissociative Identity Disorder. 

1. Dissociative Amnesia: Sudden memory loss of important personal information, usually  related to a traumatic or stressful event. Not due to physical brain injury, it’s  psychological. 

• Why it happens: The mind blocks out distressing memories to protect the person  emotionally. It’s a psychological defense mechanism. 

A. Dissociative Amnesia with Fugue: Forgetting identity and traveling away to start a  new life. 

o Example: someone disappears after a natural disaster, is found weeks later in a  new city living under a different name, unaware they forgot their past. B. Dissociative Amnesia without Fugue:  Involves memory loss of personal  information, but does not include travel or the creation of a new identity. o Example: After witnessing a violent incident, a person cannot remember key  details about their life (e.g., their name, relationships, or where they live), but  remains in their usual location. 

2. Dissociative Identity Disorder (DID): The presence of two or more distinct personality  states (“alters”) that control a person’s behavior at different times. 

• Often misrepresented in movies as “split personality,” but it's far more complex. • Symptoms: 

o Disruptions in identity: Alters can differ in name, gender, voice, behavior, even  allergies or handedness. 

o Memory gaps: The main personality often has no memory of what happened  when another alter was in control. 

o Emotional detachment: Feeling like you’re observing your life rather than living  it. 

What Are Trauma and Stressor-Related Disorders? 

− These are psychological disorders that develop after exposure to trauma or prolonged  stress. They used to be part of the anxiety disorders, but now have their own category in  the DSM-5. 

− Trauma and stressor-related disorders are characterized by exposure to a traumatic or  stress event with subsequent psychological distress. 

− Causes: The experience of trauma such as physical/sexual/emotional abuse or natural  disaster or war or personal loss or stress. 

− Symptoms of trauma and stressor related disorders: 

• Hyper vigilance, Severe Anxiety 

• Flashbacks to traumatic or stressful experiences 

• Insomnia 

• Emotional detachment 

• Hostility 

− The disorder in this category in scope for AP Psychology: posttraumatic stress disorder. 1. Post-Traumatic Stress Disorder (PTSD): 

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• Occurs after exposure to trauma either directly, by witnessing it, or by hearing  about it happening to someone close. 

• Example: After surviving a car crash, Maya avoids highways, flinches at loud braking  sounds, has nightmares, and feels disconnected from her friends. These symptoms  have lasted for months and interfere with her life. 

• PTSD Symptoms - The “Four Clusters”: 

A. Intrusion: 

o Recurrent, unwanted memories or nightmares 

o Flashbacks (reliving the trauma) 

o Distress when exposed to reminders (sounds, smells, anniversaries) B. Avoidance: 

o Avoiding thoughts, places, or people associated with the trauma 

o Emotional numbing or shutting down 

C. Cognitive and Mood Changes: 

o Persistent negative thoughts and beliefs 

o Memory problems (e.g., not remembering parts of the event) 

o Feelings of guilt, shame, or detachment 

D. Arousal and Reactivity: 

o Hypervigilance (always “on edge”) 

o Easily startled 

o Sleep problems 

o Angry outbursts or self-destructive behavior 

What Are Feeding and Eating Disorders? 

− Feeding and eating disorders are characterized by altered consumption or absorption of  food that impairs health or psychological functioning.  

• The two disorder in this category in scope for AP Psychology: Anorexia Nervosa and  Bulimia Nervosa. 

1. Anorexia Nervosa: “Starving in pursuit of control.” 

− Symptoms: 

• Significant restriction of food intake → leads to dangerously low body weight • Intense fear of gaining weight even if already underweight 

• Distorted body image (they perceive themselves as overweight even if severely  thin) 

• Denial of the seriousness of their condition 

• Excessive exercise or obsession with calorie counting 

− Causes of Anorexia Nervosa 

• Biological/Genetic: 

o Genetic predisposition: Family history of eating disorders or anxiety may  increase vulnerability. 

o Neurotransmitter imbalance: Disruptions in serotonin levels may affect mood  and appetite regulation. 

o Brain imaging studies: Suggest abnormal activity in regions involved in reward,  control, and self-perception. 

• Cognitive: 

o Distorted body image: Believing one is overweight even when underweight due  to cognitive distortions like body dysmorphia. 

o Perfectionism and control: An intense need to achieve unrealistic body  standards or control one’s body through food.

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• Behavioral: 

o Positive reinforcement: Compliments or praise for weight loss can reinforce  disordered behaviors. 

o Negative reinforcement: Restricting food reduces anxiety or guilt, reinforcing  the behavior. 

• Social/Cultural: 

o Media and societal expectations promote unrealistic body standards. o Overly controlling or perfectionistic family environments may contribute to the  disorder. 

2. Bulimia Nervosa: “Trapped in a binge-purge cycle.” 

• Involving recurrent episodes of binge eating followed by compensatory purge  behaviors such as vomiting, fasting, excessive exercise, or misuse of laxatives to  prevent weight gain.  

• Often has normal weight or slightly above average weight 

• Example: A college student secretly eats a full pizza and two cakes in one sitting,  then purges in the bathroom and runs for two hours to “undo” the calories. − Causes: 

• Biological: 

o Family history: Increases risk for bulimia. 

o Neurotransmitter Imbalances: in serotonin and dopamine may affect impulsivity  and appetite regulation. 

o Hypothalamus disruption may impair hunger/fullness signals contributing to  binging episodes. 

• Cognitive: 

o Individuals judge their self-worth based on weight or appearance. 

o All-or-nothing thinking: "If I eat one unhealthy thing, I’ve completely failed." One  bad meal feels like total failure, triggering a binge-purge cycle. 

• Behavioral: 

o Negative reinforcement: purging temporarily relieves shame or guilt after  bingeing. 

o Learned pattern: Bingeing becomes a coping response to emotional stress,  followed by purging to regain control. 

• Social/Cultural: 

o Social Comparison and Media influence: Exposure to unrealistic body ideals may  increase pressure to be thin. 

o Cultural norms: In cultures that value appearance and thinness, bulimia may  develop as a way to meet expectations while still indulging in restricted foods. 

What Are Personality Disorders? 

− Personality disorders are characterized by enduring rigid patterns of internal  experience and behavior such in thinking feeling and behavior, that is: • Deviant from one’s culture and cultural norms 

• Pervasive and inflexible across many areas of life 

• Begins in adolescence or early adulthood 

• Stable over time 

• Causes significant personal distress and impairment in functioning − Imagine it like a lens through which the person views the world—and the lens itself is  distorted.

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• Unlike most disorders (like anxiety or depression), personality disorders are not  “episodes” they’re pervasive and persistent patterns that feel normal to the person  experiencing them. Always present, shaping how the person sees the world every  single day. 

− There are three Clusters (A, B, C): Mnemonic: Weird (Alone), Wild (Drama), Worried  (Concerned). 

I. Cluster A – “Weird”:  

• These individuals often appear odd or eccentric. Their thinking patterns tend to  isolate them from others, even if they don’t always realize it. 

A. Paranoid PD:  

• Catch Phrase: “Everyone’s out to get me.”  

• Deep distrust and suspicion of others’ motives 

• Believes others are exploiting or harming them without evidence 

• Hyper vigilant and reluctant to confide in others 

• Example: A student thinks classmates are talking behind their back—even when  there's no proof. 

B. Schizoid PD:  

• Catch Phrase: “I’d rather be alone forever.”  

• Lacks interest in close relationships even family or romantic ones 

• Emotionally cold and detached 

• Prefers solitary activities  

• Not the same as social anxiety: They’re not scared to socialize, they just don’t care  to. 

• Example: A person who never goes to social gatherings not out of anxiety, but  because they don’t see the need. 

C. Schizotypal PD:  

• Catch Phrase: “I have magical powers, and my thoughts shape reality.”  • Eccentric or magical thinking (believes in telepathy, signs in dreams, etc.) • Odd speech or behavior 

• Difference from Schizophrenia: No full-blown delusions or hallucinations just odd  beliefs and behavior. 

• Example: A person believes their dreams predict the future and that people can read  their thoughts. 

II. Cluster B – “Wild”: Dramatic, emotional, Unpredictable 

• These individuals are impulsive, emotionally intense, and often have stormy  relationships. 

A. Antisocial PD:  

• Catch Phrase: “Rules don’t apply to me.”  

• Violates others' rights, lies, manipulates, lacks remorse 

• Often engages in criminal behavior or conning others 

• Repeated trouble with authority figures 

• Must be 18+ to diagnose; often shows signs in childhood (conduct disorder) • Example: Someone repeatedly cheats, steals, and hurts others without guilt. B. Borderline PD:  

• Catch Phrase: “I love you… I hate you… Don’t leave me!” → Instability in  relationships, intense emotions, fear of abandonment, impulsivity 

• Instability in emotions, relationships, and self-image 

• Fear of abandonment; may cling or lash out

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• Impulsive behavior (e.g., binge eating, self-harm, reckless sex) 

• Chronic feelings of emptiness 

• Difference from Bipolar: BPD moods shift in minutes/hours, not  

days/weeks/Months, and are usually triggered by relationships. 

• Example: Someone tells their partner “You’re the only one I love” in the morning  and screams “You never cared about me!” by night. 

C. Histrionic PD:  

• Catch Phrase: “Look at me!”  

• Needs to be the center of attention 

• Self-centered emoting 

• Dramatic, theatrical and exaggerated emotions 

• Uses appearance or flirtation to gain attention 

• Example: Wears bright red to a funeral. 

D. Narcissistic PD:  

• “I’m better than everyone.”  

• Inflated sense of self-importance 

• Craves admiration and lacks empathy 

• Believes they're special and deserves special treatment 

• Easily hurt by criticism 

• Example: Dominates every conversation, expects praise constantly, and gets angry  when others don’t admire them. 

III. Cluster C – “Worried”:  

• These individuals are dominated by fear and concern (of rejection, being alone, or  losing control). 

A. Avoidant PD:  

• Catch Phrase: “I want friends, but I’m terrified of rejection.”  

• Socially inhibited due to extreme fear of judgment or criticism 

• Desperately wants relationships but avoids them 

• Feels inadequate and inferior 

• Difference from Social Anxiety Disorder: This is a pervasive pattern, not tied to  specific performance situations. 

• Example: Someone gets invited to a party but hides in the bathroom the whole time,  afraid people will laugh at them. 

B. Dependent PD:  

• Catch Phrase; “I can’t make a decision without you.”  

• Excessive need to be cared for 

• Clingy and submissive 

• Has trouble making decisions without reassurance 

• Fears separation, tolerates poor treatment to avoid abandonment 

• Example: Someone refuses to break up with a toxic partner because they’re terrified  of being alone. 

C. Obsessive-Compulsive PD:  

• “Everything must be perfect and my way”  

• Preoccupied with order, perfection, rules, and control 

• Rigid and inflexible; struggles to delegate tasks 

• Difference from OCD: it doesn’t include obsessions and impulsions. 

• Example: Monica from Friends 

− Causes of Personality Disorders:

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• Biological Causes: 

o Inherited temperament: Individuals may be born with certain personality traits  (e.g., emotional sensitivity, impulsivity) that increase risk when combined with  environmental stressors. 

o Brain structure differences (e.g., overactive amygdala, underactive prefrontal  cortex) 

• Cognitive Causes: 

o Maladaptive thought patterns formed from early experiences and distorted  beliefs about self, others, and the world.  

o Experiences such as abuse, neglect, or abandonment can lead to beliefs that  others cannot be trusted or that emotions are dangerous. 

o Examples: “Everyone is out to get me” or “I don’t need anyone.” • Social/Cultural Causes: 

o Growing up in unstable or inconsistent environments (e.g., with abuse, neglect,  invalidation, or enmeshment) may prevent healthy identity and relationship  development. 

o Societies that value emotional suppression, rigid roles, or extreme independence  may discourage healthy emotional expression, increasing risk. 

o Repeated rejection or exclusion can contribute to the development of distrust or  detachment seen in certain personality disorders. 

• Behavioral Causes: 

o Reinforced patterns: Dysfunctional behaviors (e.g., manipulation, aggression,  attention-seeking) may be reinforced if they achieve desired outcomes.  o Example: Manipulation = gets what I want → repeated → antisocial pattern o Example: Avoiding emotional closeness or responsibilities may be reinforced by  temporary relief from anxiety or rejection.