Chapter 4: Psychological Disorders
Learning Objectives:
- Understand the basic issues in abnormal behavior and the criteria to identify them
- Appreciate the factors which cause abnormal behavior
- Explain the different models of abnormal behavior
- Describe the major psychological disorders
Introduction
Psychological disorders (mental disorders) involve failures in adaptation to life challenges. Abnormal Psychology focuses on maladaptive behavior - its causes, consequences, and treatment.
Concepts of Abnormality and Psychological Disorders
The 'four Ds' criteria for psychological disorders:
- Deviance: Different, extreme, unusual behavior
- Distressing: Unpleasant and upsetting
- Dysfunctional: Interferes with daily activities
- Dangerous: To self or others
Approaches to Defining Abnormality
- Deviation from social norms: Behavior that breaks societal norms
- Maladaptive approach: Behavior that interferes with well-being and growth
Historical Background
Three recurring perspectives in history:
- Supernatural: Evil spirits/demons causing abnormal behavior
- Biological/Organic: Body/brain malfunctions
- Psychological: Inadequate thinking/feeling/perceiving
Modern approach: Biopsychosocial model - interaction of biological, psychological and social factors.
Classification of Psychological Disorders
Two major classification systems:
- DSM-5: Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association)
- ICD-10: International Classification of Diseases (WHO)
Factors Underlying Abnormal Behavior
Biological Factors
- Faulty genes, endocrine imbalances, malnutrition, injuries
- Neurotransmitter abnormalities:
- Low GABA → Anxiety disorders
- Excess dopamine → Schizophrenia
- Low serotonin → Depression
- Genetic factors in bipolar disorder, schizophrenia, intellectual disability
Psychological Models
- Psychodynamic model: Unconscious mental conflicts (Freud)
- Behavioral model: Learned maladaptive behaviors
- Cognitive model: Irrational assumptions and illogical thinking
- Humanistic-existential model: Failure in self-actualization or giving meaning to existence
Socio-cultural Factors
- War, violence, discrimination, economic problems, rapid social change
- Family systems (e.g., enmeshed families)
- Lack of social support
- Societal labels and roles
Diathesis-Stress Model
Psychological disorders develop when:
- Biological predisposition (diathesis) exists
- Person is vulnerable to develop disorder
- Exposed to pathogenic stressors
Major Psychological Disorders
Anxiety Disorders
Excessive anxiety that interferes with functioning. Symptoms: rapid heart rate, shortness of breath, dizziness, sweating, etc.
| Disorder |
Description |
| Generalized Anxiety Disorder |
Prolonged, vague, intense fears not attached to any object |
| Panic Disorder |
Recurrent anxiety attacks with intense terror |
| Phobias |
Irrational fears of specific objects/situations:
- Specific phobias (e.g., fear of animals)
- Social anxiety disorder
- Agoraphobia (fear of unfamiliar situations)
|
| Separation Anxiety Disorder |
Developmentally inappropriate fear/anxiety about separation |
Obsessive-Compulsive and Related Disorders
- Obsessions: Uncontrollable preoccupation with specific ideas
- Compulsions: Need to perform certain behaviors repeatedly
- Other disorders: Hoarding disorder, trichotillomania (hair-pulling), excoriation (skin-picking)
Trauma- and Stressor-Related Disorders
- PTSD: After trauma (war, disaster, accident) - flashbacks, emotional numbing
- Adjustment disorders, acute stress disorder
Somatic Symptom and Related Disorders
- Physical symptoms without physical disease
- Somatic symptom disorder: Persistent body-related symptoms with health preoccupation
- Illness anxiety disorder: Preoccupation with developing serious illness
- Conversion disorder: Loss of body function (e.g., paralysis) without physical cause
Dissociative Disorders
- Severance of connections between ideas and emotions
- Dissociative amnesia: Extensive selective memory loss
- Dissociative fugue: Travel + new identity + amnesia
- Dissociative identity disorder: Multiple personalities
- Depersonalization/Derealization: Feeling separated from self/reality
Depressive Disorders
- Period of depressed mood/loss of interest
- Symptoms: weight changes, sleep problems, fatigue, worthlessness, suicidal thoughts
- Risk factors: genetics, age, gender (women more at risk), negative life events, lack of social support
Bipolar and Related Disorders
- Alternating episodes of mania and depression
- Types: Bipolar I, Bipolar II, Cyclothymic disorder
- Mania symptoms: elevated mood, decreased need for sleep, grandiosity, racing thoughts
Schizophrenia Spectrum and Other Psychotic Disorders
Characterized by disturbed thought processes, strange perceptions, unusual emotional states, motor abnormalities.
Symptoms:
- Positive symptoms (excesses):
- Delusions (false beliefs): persecution, reference, grandeur, control
- Disorganized thinking/speech
- Hallucinations (false perceptions): auditory most common
- Inappropriate affect
- Negative symptoms (deficits):
- Alogia (poverty of speech)
- Blunted/flat affect
- Avolition (lack of motivation)
- Social withdrawal
- Psychomotor symptoms:
- Catatonia (stupor, rigidity, posturing)
Neurodevelopmental Disorders
Manifest in early development, hamper functioning.
| Disorder |
Description |
| ADHD |
Inattention and hyperactivity-impulsivity |
| Autism Spectrum Disorder |
Impairments in social interaction and communication, restricted interests |
| Intellectual Disability |
Below average IQ (≤70) + deficits in adaptive behavior before age 18 |
| Specific Learning Disorder |
Difficulty in reading, writing, mathematics |
Disruptive, Impulse-Control and Conduct Disorders
- Oppositional Defiant Disorder: Stubbornness, irritability, defiance
- Conduct Disorder: Violation of societal norms/rights of others
Feeding and Eating Disorders
- Anorexia nervosa: Distorted body image, self-starvation
- Bulimia nervosa: Binge eating followed by purging
- Binge eating disorder: Frequent out-of-control eating
Substance-Related and Addictive Disorders
Problems from regular substance use that alters thinking, feeling, behavior.
| Substance |
Effects |
| Alcohol |
Interferes with social behavior, thinking, work; physical health damage |
| Heroin |
Dependence, overdose can cause death by respiratory failure |
| Cocaine |
Memory/attention problems, dependence, dangerous physical effects |
Summary
- Abnormal behavior is deviant, distressing, dysfunctional, dangerous
- Historical perspectives: supernatural, biological, psychological
- Modern approach: biopsychosocial model
- Classification systems: DSM-5 and ICD-10
- Models: biological, psychodynamic, behavioral, cognitive, humanistic-existential, diathesis-stress, socio-cultural
- Major disorders: anxiety, OCD, trauma-related, somatic symptom, dissociative, depressive, bipolar, schizophrenia, neurodevelopmental, conduct, eating, substance-related
Key Terms
- Abnormal psychology: Study of maladaptive behavior
- Anxiety: Diffuse, unpleasant feeling of fear
- Autism spectrum disorder: Social/communication impairments, restricted interests
- Bipolar disorder: Alternating mania and depression
- Delusions: False firmly-held beliefs
- Depressive disorders: Periods of depressed mood/loss of interest
- Diathesis-stress model: Predisposition + stress → disorder
- Hallucinations: False sensory perceptions
- Neurodevelopmental disorders: Early-onset impairments (ADHD, autism etc.)
- Neurotransmitters: Chemicals enabling neuron communication
- Obsessive-compulsive disorder: Obsessions + compulsions
- Phobias: Irrational specific fears
- Schizophrenia: Psychotic disorder with thought/emotional disturbances
- Somatic symptom disorders: Physical symptoms without physical cause
- Substance-related disorders: Maladaptive substance use patterns