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Disclaimer: Do not use information in this unit as medical advice or to diagnose yourselves or others because only professionals can do that. It’s normal and common to experience some of the symptoms listed here but that does not mean that you have a disorder.
Psychological Disorders
What is Abnormal Behavior?
Deviant: Behavior that violates social norms or expectations.
Distressful: Causes significant personal distress or discomfort.
Dysfunctional: Interferes with daily life and functioning.
Dangerous: Poses a risk of harm to oneself or others.
Unjustifiable: No rational basis for the behavior.
History of Understanding Psychological Disorders
Early Treatments: Harsh and often ineffective, including trephination (drilling holes in the skull), exorcism, and confinement.
The Medical Model: Views mental illness as a disease that can be diagnosed and treated, often with medication and hospitalization.
The Biopsychosocial Approach: Recognizes that biological, psychological, and social factors all contribute to mental illness.
Perspectives on Psychological Disorders
Psychoanalytic: Disorders stem from unresolved childhood conflicts and unconscious desires.
Behavioral: Disorders are learned behaviors, acquired through conditioning and reinforcement.
Cognitive: Disorders arise from faulty thinking patterns and beliefs.
Humanistic: Disorders result from a lack of self-worth and conditions of worth placed upon individuals.
Sociocultural: Disorders are influenced by social and cultural factors, including family dynamics and societal pressures.
Key Points:
Defining Abnormality: It's complex, with multiple factors to consider.
Historical Context: Understanding has evolved significantly, leading to more humane and effective treatments.
Multiple Perspectives: Different perspectives offer unique insights into the causes and treatment of psychological disorders.
Classifying and Diagnosing Psychological Disorders
DSM-5 (Diagnostic and Statistical Manual of Mental Disorders):
Published by the American Psychiatric Association
The most widely used system for classifying and diagnosing mental disorders.
The Rosenhan Experiment:
Demonstrated the difficulty of distinguishing between "normal" and "abnormal" behavior in a hospital setting.
Raised questions about the reliability and validity of psychiatric diagnoses.
Anxiety Disorders
Key Features: Excessive fear, worry, and apprehension that interferes with daily life.
Types of Anxiety Disorders:
Generalized Anxiety Disorder (GAD):
Persistent, excessive worry about a variety of things.
Difficulty controlling the worry.
Physical symptoms (e.g., muscle tension, restlessness, fatigue).
Panic Disorder:
Sudden and repeated panic attacks (intense fear and physical symptoms).
Fear of having future panic attacks.
Phobias:
Specific Phobia: Intense fear of a specific object or situation (e.g., spiders, heights).
Social Anxiety Disorder (Social Phobia): Fear of social situations and scrutiny by others.
Agoraphobia: Fear of open or public spaces, often linked to panic disorder.
Obsessive-Compulsive Disorder (OCD):
Obsessions: Persistent, unwanted thoughts or images that cause anxiety.
Compulsions: Repetitive behaviors or mental acts performed to reduce anxiety (e.g., handwashing, checking).
Brain Imaging: PET scans show increased activity in the frontal lobe.
OCD-Related Disorders
Body Dysmorphic Disorder: Preoccupation with an imagined or exaggerated flaw in appearance.
Hoarding Disorder: Persistent difficulty discarding possessions, leading to clutter and distress.
Trichotillomania: Recurrent pulling out of one's own hair.
Excoriation Disorder: Repeated picking at one's own skin.
Trauma and Stressor-Related Disorders
Post-Traumatic Stress Disorder (PTSD):
Develops after experiencing or witnessing a traumatic event.
Symptoms: Flashbacks, nightmares, anxiety, avoidance of reminders.
Acute Stress Disorder: Similar to PTSD but symptoms occur immediately after the trauma and last up to one month.
Dissociative Disorders
Dissociative Disorders: Conditions involving disruptions in memory, identity, or consciousness.
Dissociative Identity Disorder (DID):
Formerly called Multiple Personality Disorder.
Presence of two or more distinct personalities within one individual.
Personality Disorders
Three Clusters:
Cluster A: Odd or eccentric behavior (e.g., paranoid, schizoid).
Cluster B: Dramatic, emotional, or erratic behavior (e.g., borderline, narcissistic, antisocial).
Cluster C: Anxious or fearful behavior (e.g., avoidant, dependent, obsessive-compulsive).
Cluster A
Paranoid Personality Disorder is characterized by a persistent distrust of others and suspicion.
Schizoid Personality Disorder involves a lack of interest in forming social relationships and limited emotional expression.
Schizotypal Personality Disorder is marked by difficulties in social interactions, unusual thoughts, and distorted perceptions of reality.
Cluster B
Borderline Personality Disorder is characterized by unstable moods, self-image, and behavior, often leading to impulsive actions and relationship problems.
Histrionic Personality Disorder involves seeking excessive attention through seductive behavior and a strong need for approval.
Narcissistic Personality Disorder is defined by an inflated sense of self-importance, a constant need for admiration, and a lack of empathy.
Cluster C
Avoidant Personality Disorder is characterized by extreme social inhibition, feelings of inadequacy, and a fear of rejection, making it challenging to maintain relationships.
Dependent Personality Disorder involves a reliance on others for decision-making and reassurance, leading to anxiety when alone.
Obsessive-Compulsive Personality Disorder is marked by a fixation on perfectionism, orderliness, and a lack of flexibility in interpersonal relationships.
Personality Disorders and Mood Disorders
Personality Disorders
Antisocial Personality Disorder: A pattern of disregard for and violation of the rights of others.
Key features: Repeatedly breaking laws, lying, impulsivity, aggression, lack of remorse.
Not the same as being "antisocial" (shy or withdrawn).
Conduct Disorder: A childhood disorder characterized by continued violation of rules and social norms.
Oppositional Defiant Disorder: A pattern of angry, defiant, and argumentative behavior, particularly toward authority figures.
Mood Disorders
Major Depressive Disorder:
Persistent feelings of sadness, hopelessness, and loss of interest in activities.
May also include changes in sleep, appetite, and concentration.
Biological Factors: Linked to imbalances in neurotransmitters like serotonin and dopamine.
Social-Cognitive Factors: Negative thoughts and behaviors can reinforce depression.
Persistent Depressive Disorder (Dysthymia): A less severe but longer-lasting form of depression.
Bipolar Disorder: Mood swings between depression and mania.
Manic Symptoms: Elevated mood, hyperactivity, racing thoughts, impulsive behavior.
Bipolar I: Experiences full manic episodes and usually major depressive episodes.
Bipolar II: Experiences hypomania (less severe mania) and major depressive episodes.
Cyclothymic Disorder: Less severe but longer-lasting mood swings (hypomania and mild depression).
Neurodevelopmental Disorders
Definition: Conditions affecting the development of essential brain functions, leading to difficulties with social skills, language, perception, or motor behavior.
Autism Spectrum Disorder (ASD):
Key Features: Challenges with social interaction, communication, and repetitive behaviors or interests.
Spectrum: Ranges from individuals with high functioning to those needing significant support.
Attention-Deficit/Hyperactivity Disorder (ADHD):
Key Features: Inattention, hyperactivity, and impulsivity.
Inattention: Difficulty focusing, easily distracted, trouble following through on tasks.
Somatic Symptom and Related Disorders
Definition: Physical symptoms that cannot be fully explained by a medical condition and are believed to be linked to psychological factors.
Types:
Conversion Disorder: Loss of physical function (e.g., paralysis, blindness) without a medical explanation, often following a stressful event.
Illness Anxiety Disorder: Preoccupation with having or getting a serious illness, despite medical reassurance.
Factitious Disorders: Intentionally faking or inducing symptoms to assume the sick role.
Munchausen Syndrome: Deliberately faking or causing illness in oneself.
Munchausen Syndrome by Proxy: Faking or causing illness in another person (often a child).
Ganser Syndrome: Giving approximate or nonsensical answers to questions.
Schizophrenia
Psychosis: A break from reality, involving impaired thinking and perception.
Schizophrenia: A chronic mental disorder characterized by a split from reality, manifesting in:
Disorganized Thinking and Delusions: False beliefs that are firmly held despite evidence to the contrary.
Disturbed Perceptions (Hallucinations): Sensory experiences without any external stimulus. Most common: Hearing voices.
Inappropriate Emotions and Actions: Laughing at inappropriate times, flat affect (lack of emotion), catatonic behavior.
Positive Symptoms: Excesses or distortions of normal functions. Often more prominent in early stages.
Examples: Delusions, hallucinations, disorganized speech and behavior.
Negative Symptoms: Reductions or losses of normal functions.
Examples: Flat affect, apathy, poverty of speech (reduced speech).
Other Symptoms:
Paranoia: Extreme suspiciousness or unfounded fear of persecution.
Catatonia: Marked decrease in reactivity to the environment, including:
Immobility or excessive, purposeless movement.
Extreme negativism (resisting instructions).
Repetition of speech or movements (echolalia or echopraxia).
Brain Abnormalities:
Dopamine: Schizophrenia is associated with an excess of dopamine activity in certain brain regions.
Other Brain Changes: Reduced frontal lobe activity, enlarged ventricles (fluid-filled spaces), and abnormal thalamus activity.
Treatment of Psychological Disorders
Types of Therapy
Psychotherapy: "Talk therapy," using psychological techniques to treat mental health issues.
Biomedical Therapy: Using medications or procedures that act on the nervous system to treat psychological disorders.
Eclectic Approach: Combining different therapeutic approaches to tailor treatment to the individual's needs.
Psychoanalysis (Freud)
Key Idea: Psychological problems stem from unconscious conflicts and repressed childhood experiences.
Goal: Bring unconscious thoughts and feelings into conscious awareness to gain insight and resolve conflicts.
Techniques:
Free Association: Patient says whatever comes to mind, revealing unconscious thoughts.
Resistance: The patient's blocking of anxiety-provoking thoughts during free association.
Transference: The patient's transfer of emotions (love or hate) linked with other relationships onto the therapist.
Criticisms of Psychoanalysis:
Time-consuming and expensive: Can take years and be costly.
Difficult to prove or disprove: Relies heavily on interpretations of the unconscious, making it hard to scientifically validate.
Humanistic Therapies
Goal: Help individuals achieve self-actualization and personal growth by increasing self-awareness and self-acceptance.
Client-Centered Therapy (Carl Rogers):
Therapist provides a supportive and non-judgmental environment for the client.
Focuses on active listening and reflecting back the client's feelings and thoughts to help them gain insight and self-understanding.
Behavior Therapies
Goal: Change unwanted behaviors using learning principles.
Counterconditioning: Pairing a feared or unwanted stimulus with a new, more positive response.
Exposure Therapy: Exposing individuals to the feared stimulus gradually and repeatedly until the fear diminishes.
Systematic Desensitization: A specific type of exposure therapy where relaxation techniques are paired with gradually increasing exposure to the feared stimulus.
Aversive Conditioning: Pairing an unpleasant stimulus with an unwanted behavior to decrease its frequency. Example: Pairing nausea-inducing medication with alcohol to reduce alcohol consumption.
Operant Conditioning:
Behavior Modification: Using rewards and punishments to increase or decrease specific behaviors.
Token Economy: A system where desired behaviors are rewarded with tokens that can be exchanged for privileges or rewards. Often used in institutional settings.
Cognitive Therapy
Goal: Change unhelpful thoughts and beliefs that contribute to psychological problems.
Key Idea: Our thoughts influence our feelings and behaviors.
Cognitive Therapy (Aaron Beck):
Helps patients identify and challenge negative thought patterns associated with depression and other disorders.
Cognitive-Behavioral Therapy (CBT):
Combines cognitive therapy with techniques to change behavior.
Focuses on both modifying thoughts and developing coping skills.
Effective for a wide range of disorders.
Group Therapy
Benefits:
Cost-effective.
Provides social support and allows clients to see that others share similar struggles.
Evaluating Therapies
Client Testimonials:
Clients often report positive experiences, but this may be influenced by factors like:
The natural course of time (crises may subside on their own).
The desire to justify the time and money spent on therapy.
Research:
Controlled studies generally show that therapy is effective, with treated individuals faring better than untreated ones.
Types of Therapists and Their Training
Clinical Psychologists:
Hold a Ph.D. or Psy.D. in psychology.
Trained in research, assessment, and therapy.
Clinical or Psychiatric Social Workers:
Hold a Master's degree in social work.
Provide psychotherapy, often focusing on everyday problems and connecting clients with community resources.
Biomedical Therapies
Antipsychotic Drugs:
Function: Reduce symptoms of psychosis (hallucinations, delusions) by blocking dopamine receptors.
Examples: Chlorpromazine (Thorazine), Clozapine
Antimanic Drugs (Mood Stabilizers):
Function: Reduce manic symptoms in bipolar disorder.
Example: Lithium
Antidepressant Drugs:
Function: Increase the availability of neurotransmitters like serotonin and norepinephrine.
Types:
SSRIs (Selective Serotonin Reuptake Inhibitors): Block reuptake of serotonin.
SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors): Block reuptake of both serotonin and norepinephrine.
Antianxiety Drugs:
Function: Reduce anxiety and tension.
Example: Benzodiazepines (e.g., Xanax, Valium)
Electroconvulsive Therapy (ECT):
Function: Brief electrical current is passed through the brain.
Used for: Severe depression that hasn't responded to other treatments.
Mechanism: May work by resetting brain chemistry or stimulating neurogenesis (growth of new neurons).
Psychosurgery:
Function: Surgical procedures that destroy or remove brain tissue.
Example: Lobotomy (rarely used today)
Modern Use: Very limited, only for severe and treatment-resistant cases.
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