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Psychological Disorders

Patterns of behavior or mental processes that are connected with emotional distress or significant impairment in functioning.


Biopsychosocial Model
(or interactionist model)

Explains psychological disorders in terms of a combination of
(a) biological vulnerabilities;
(b) psychological factors such as conditioning, exposure to stress, and self-defeating thoughts about stressors; and
(c) sociocultural factors such as family relationships, unemployment, and cultural beliefs and expectations.

For example, schizophrenia and depression are found around the world, which appears to support other evidence for biological contributors to these disorders. Yet psychological factors such as family stresses and losses can also play roles in their development.


Diathesis–Stress Model

Assumes that there may be biological differences between individuals—diatheses—that explain why some people develop certain psychological disorders under stress, whereas others do not. In the case of schizophrenia, as we will see, the diathesis (or biological difference) would appear to be a genetic vulnerability to schizophrenia.



The view that psychological disorders can be explained in terms of an underlying vulnerability.



A legal term descriptive of a person judged to be incapable of recognizing right from wrong or of conforming his or her behavior to the law.



Diagnostic and statistical manual of mental disorders.
*IV = 1994, TR=2000
*V will be out in May.
*Divided into classifications (anxiety, mood)
*ICD is used in Europe

Although the DSM is widely used, researchers have some concerns about it. Two of them involve the reliability and validity of the diagnostic standards. The DSM might be considered reliable if different interviewers or raters make the same diagnosis when they evaluate the same people. The DSM might be considered valid if the diagnoses described in the manual correspond to clusters of behaviors observed in the real world. A specific type of validity—predictive validity—means that if a diagnosis is valid, then we should be able to predict what will happen to the person over time (that is, the course of the disorder) and what type of treatment may be of help.


Anxiety Disorders

Anxiety disorders have psychological and physical symptoms. The psychological symptoms include worrying, fear of the worst happening, fear of losing control, nervousness, and inability to relax. The physical symptoms reflect arousal—or “overarousal”—of the sympathetic branch of the autonomic nervous system: trembling, sweating, a pounding or racing heart, elevated blood pressure (a flushed face), and faintness. Anxiety is an appropriate response to a real threat, but it can be abnormal when it is excessive, when it comes out of nowhere (that is, when events do not seem to warrant it), and when it prevents us from doing important things such as going for medical exams or working with other people. Some anxiety disorders even prevent people from leaving home.


Anxiety Disorders
-Specific Phobias

are excessive, irrational fears of specific objects or situations, such as spiders, snakes, or heights. One specific phobia is fear of elevators. Some people will not enter elevators despite the hardships they incur as a result (such as walking up six flights of steps). Yes, the cable could break. The ventilation could fail. One could be stuck in midair waiting for repairs. These problems are uncommon, however, and it does not make sense for most people to walk up and down several flights of stairs to elude them.

Other specific phobias include claustrophobia (fear of tight or enclosed places), acrophobia (fear of heights), and fear of mice, snakes, and other creepy-crawlies. (Fear of spiders is technically called arachnophobia.) Fears of animals and imaginary creatures are common among children and therefore not considered abnormal.


Anxiety Disorders
-Social Phobias

are persistent fears of scrutiny by others or of doing something that will be humiliating or embarrassing. Excessive fear of public speaking is a common social phobia.


Anxiety Disorders

May affect 3% to 4% of adults (Kessler et al., 2005). Agoraphobia is derived from the Greek words meaning “fear of the marketplace,” or fear of being out in open, busy areas. Some people who receive this diagnosis refuse to venture out of their homes, especially alone. They find it difficult to hold a job or to maintain an ordinary social life.


Anxiety Disorders
-Panic Disorder

An abrupt anxiety attack that is apparently unrelated to specific objects or situations. People with panic disorder experience strong cardiac-related sensations: shortness of breath, heavy sweating, tremors, and pounding of the heart. Many think they are having a heart attack. Levels of cortisol (a stress hormone) in the saliva are elevated during attacks. Many fear suffocation. People with the disorder may also experience choking sensations, nausea, numbness or tingling, flushes or chills, and fear of going crazy or losing control. Panic attacks may last minutes or hours. Afterward, the person usually feels drained.


Anxiety Disorders
-Generalized Anxiety Disorder

The central symptom of generalized anxiety disorder is persistent anxiety. As with panic disorder, the anxiety cannot be attributed to a phobic object, situation, or activity. Rather, it seems to be free floating. The core of the disorder appears to be pervasive worrying about numerous stressors. Symptoms include motor tension (shakiness, inability to relax, furrowed brow, fidgeting); autonomic overarousal (sweating, dry mouth, racing heart, light-headedness, frequent urinating, diarrhea); and excessive vigilance, as shown by irritability, insomnia, and a tendency to be easily distracted.


Anxiety Disorders

Is characterized by recurrent, anxiety-provoking thoughts or images that seem irrational and beyond control (obsessions) and seemingly irresistible urges to engage in thoughts or behaviors that tend to reduce the anxiety (compulsions). Obsessions are so compelling and recurrent that they disrupt daily life. They may include doubts about whether one has locked the doors and shut the windows or images such as one mother’s repeated fantasy that her children had been run over on the way home from school.


Anxiety Disorders

People diagnosed with posttraumatic stress disorder (PTSD) typically show a rapid heart rate and feelings of anxiety and helplessness following a disturbing experience. Such experiences may include a natural or human-made disaster, a threat or assault, or witnessing a death. PTSD may occur months or years after the event. It frequently occurs among firefighters, combat veterans, and people whose homes and communities have been swept away by natural disasters or who have been victims of accidents or interpersonal violence. A disorder that follows a distressing event outside the range of normal human experience and that is characterized by features such as intense fear, avoidance of stimuli associated with the event, and reliving of the event.


Anxiety Disorders
-Acute Stress Disorder

Like PTSD, acute stress disorder is characterized by feelings of anxiety and helplessness that are caused by a traumatic event. However, PTSD can occur 6 months or more after the traumatic event and tends to persist. Acute stress disorder occurs within a month of the event and lasts from 2 days to 4 weeks. Women who have been raped, for example, experience acute distress that tends to peak in severity about 3 weeks after the assault. Yet the same women may go on to experience PTSD.


Origins of Anxiety Disorders
-Psychological Views

According to the psychodynamic perspective, phobias symbolize conflicts originating in childhood. Psychodynamic theory explains generalized anxiety as persistent difficulty in repressing primitive impulses. Obsessions are explained as leakage of unconscious impulses, and compulsions are seen as acts that allow people to keep such impulses partly repressed. For example, fixation in the anal stage is theorized to be connected with development of traits such as excessive neatness of the sort that could explain some cases of obsessive–compulsive disorder. Some learning theorists, particularly behaviorists, consider phobias to be conditioned fears that were acquired in early childhood. Avoidance of feared stimuli is reinforced by the reduction of anxiety. Observational learning may also play a role in the acquisition of fears (Mineka & Oehlberg, 2008). If parents squirm, grimace, and shudder at the sight of mice, blood, or dirt on the kitchen floor, children might assume that these stimuli are awful and imitate their parents’ behavior. Cognitive theorists note that people’s appraisals of the magnitude of threats help determine whether they are traumatic and can lead to PTSD (Koster et al., 2009). People with panic attacks tend to misinterpret bodily cues and to view them as threats. Obsessions and compulsions may serve to divert attention from more frightening issues, such as “What am I going to do with my life?” When anxieties are acquired at a young age, we may later interpret them as enduring traits and label ourselves as “someone who fears __________” (you fill it in). We then live up to the labels. We also entertain thoughts that heighten and perpetuate anxiety, such as “I’ve got to get out of here” or “My heart is going to leap out of my chest.” Such ideas intensify physical signs of anxiety, disrupt planning, make stimuli seem worse than they really are, motivate avoidance, and decrease self-efficacy expectations. The belief that we will not be able to handle a threat heightens anxiety. The belief that we are in control reduces anxiety.


Origins of Anxiety Disorders
-Biological Views

Biological factors play key roles in anxiety disorders. They involve genetic factors, evolution, the autonomic nervous system, and the endocrine system.


Dissociative Disorders

Mental processes such as thoughts, emotions, memory, consciousness, even knowledge of one’s own identity—the processes that make a person feel whole—may seem to be split off from one another. Disorders in which there are sudden, temporary changes in consciousness or self-identity.


Dissociative Disorders
-Dissociative amnesia

A person with dissociative amnesia is suddenly unable to recall important personal information (that is, explicit episodic memories). The loss of memory cannot be attributed to organic problems such as a blow to the head or alcoholic intoxication. It is thus a psychological dissociative disorder and not an organic one. In the most common form, the person cannot recall events for a number of hours after a stressful incident, as in warfare or in the case of an uninjured survivor of an accident. In generalized dissociative amnesia, people forget their entire lives. Amnesia may last for hours or years. A dissociative disorder marked by loss of memory or self-identity; skills and general knowledge are usually retained.


Dissociative Disorders
-Dissociative Identity Disorder
(formerly: multiple personality disorder)

In dissociative identity disorder, two or more identities or personalities, each with distinct traits and memories, “occupy” the same person. Each identity may or may not be aware of the others or of events experienced by the others. A disorder in which a person appears to have two or more distinct identities or personalities that may alternately emerge.


Somatoform Disorders

Disorders in which people complain of physical (somatic) problems even though no physical abnormality can be found.


Somatoform Disorders

People with this disorder insist that they are suffering from a serious physical illness, even though no medical evidence of illness can be found. They become preoccupied with minor physical sensations and continue to believe that they are ill despite the reassurance of physicians that they are healthy. They may run from doctor to doctor, seeking the one who will find the causes of the sensations. Fear of illness may disrupt their work or home life.


Somatoform Disorders
-Conversion Disorder

Is characterized by a major change in, or loss of, physical functioning, although there are no medical findings to explain the loss of functioning. The behaviors are not intentionally produced. That is, the person is not faking. Conversion disorder is so named because it appears to “convert” a source of stress into a physical difficulty.


Mood Disorders

Are characterized by disturbance in expressed emotions. The disruption generally involves sadness or elation. Most instances of sadness are normal, or “run-of-the-mill.” If you have failed an important test, if you have lost money in a business venture, or if your closest friend becomes ill, it is understandable and fitting for you to be sad about it. It would be odd, in fact, if you were not affected by adversity. A disturbance in expressed emotions, generally involving excessive or inappropriate sadness or elation.


Mood Disorders
-Major Depressive Disorder

Depression is the common cold of psychological problems. People with run-of-the-mill depression may feel sad, blue, or “down in the dumps.” They may complain of lack of energy, loss of self-esteem, difficulty concentrating, loss of interest in activities and other people, pessimism, crying, and thoughts of suicide. These feelings are more intense in people with major depressive disorder. According to a nationally representative sample of more than 9,000 adults in the United States, major depressive disorder affects 5% to 7% of us within any given year and one person in six or seven over the course of our lives. About half of those with major depressive disorder experience severe symptoms such as poor appetite, serious weight loss, and agitation or psychomotor retardation. They may be unable to concentrate and make decisions. They may say that they “don’t care” anymore and in some cases attempt suicide. A minority may display faulty perception of reality—so-called psychotic behaviors. These include delusions of unworthiness, guilt for imagined wrongdoings, even the notion that one is rotting from disease. There may also be delusions, as of the Devil administering deserved punishment, or hallucinations, as of strangebodily sensations.


Mood Disorders
(formerly: manic depressive disorder)

Have mood swings from ecstatic elation to deep depression. The cycles seem to be unrelated to external events. In the elated, or manic, phase, the person may show excessive excitement or silliness, carrying jokes too far. The manic person may be argumentative. Like “Electroboy,” he or she may show poor judgment, making foolish purchases, shoplifting, destroying property, making huge contributions to charity, or giving away expensive possessions. People often find manic individuals abrasive and avoid them. They are often oversexed and too restless to sit still or sleep restfully. They often speak rapidly (showing pressured speech) and jump from topic to topic (showing rapid flight of ideas). It can be hard to get a word in edgewise.


Learned Helplessness

Research conducted by learning theorists has also found links between depression and learned helplessness. In classic research, psychologist Martin Seligman (1975) taught dogs that they were helpless to escape an electric shock. The dogs were prevented from leaving a cage in which they received repeated shocks. Later, a barrier to a safe compartment was removed, offering the animals a way out. When they were shocked again, however, the dogs made no effort to escape. They had apparently learned that they were helpless. Seligman’s dogs were also, in a sense, reinforced for doing nothing. That is, the shock eventually stopped when the dogs were showing helpless behavior—inactivity and withdrawal. “Reinforcement” might have increased the likelihood of repeating the “successful behavior”—that is, doing nothing—in a similar situation. This helpless behavior resembles that of people who are depressed.


Mood Disorders

Elated; showing excessive excitement. The very high pole on the mood scale.


Mood Disorders

Persistent mild depression. The lower end of the mood scale.


Warning Signs of Suicide

•  Changes in eating and sleeping patterns.
•  Difficulty concentrating on school or the job.
•  A sharp decline in performance and attendance at school or on the job.
•  Loss of interest in previously enjoyed activities.
•  Giving away prized possessions.
•  Complaints about physical problems when no medical basis can be found.
•  Withdrawal from social relationships.
•  Personality or mood changes.
•  Talking or writing about death or dying.
•  Abuse of drugs or alcohol.
•  A previously attempted suicide.
•  Availability of a handgun.
•  A precipitating event such as an argument, a broken romantic relationship, academic difficulties, problems on the job, loss of a friend, or trouble with the law.
•  In the case of adolescents, knowing or hearing about another teenager who has committed suicide (which can lead to so-called cluster suicides).
•  Threatening to commit suicide.


Schizophrenic Disorders

A severe psychological disorder that touches every aspect of a person’s life. It is characterized by disturbances in thought and language, perception and attention, motor activity, and mood, as well as withdrawal and absorption in daydreams or fantasy. Schizophrenia has been referred to as the worst psychological disorder affecting human beings. It afflicts nearly 1% of the population worldwide. Its onset occurs relatively early in life, and its adverse effects tend to endure.


Schizophrenic Disorders

In schizophrenia, whatever can go wrong, psychologically, seems to go wrong. There are disturbances in thinking, language, perception, motor behavior, and social interaction. People with schizophrenia may have positive symptoms, negative symptoms, or both. Positive symptoms are the inappropriate kinds of behavior we find in afflicted people, including, for example, agitated behavior, vivid hallucinations, unshakable delusions, disorganized thinking, and nonsensical speech. Negative symptoms are those that reflect the absence of appropriate behavior. We see them in flat, emotionless voices; blank faces; rigid, motionless bodies; and mutism.



False, persistent beliefs that are unsubstantiated by sensory or objective evidence. Many people with schizophrenia have unshakeable delusions of grandeur, persecution, or reference (Freeman et al., 2010). In the case of delusions of grandeur, a person may believe that he is a famous historical figure such as Jesus or a person on a special mission. He may have grand, illogical plans for saving the world. People with delusions of persecution may believe that they are sought by the Mafia, CIA, FBI, or some other group. Paranoid individuals tend to jump to conclusions that people intend to do them harm based on little evidence. People with delusions of reference erroneously believe that other people are talking about them or referring to them. For example, a woman with delusions of reference said that news stories contained coded information about her. A man with such delusions complained that neighbors had “bugged” his walls with “radios.” Other people with schizophrenia have had delusions that they had committed unpardonable sins, that they were rotting away from disease, or that they or the world did not exist.



Refusal to talk.



A condition in which the senses, thought, and movement are dulled.


Schizophrenic Disorders
-Disorganized Type

A type of schizophrenia characterized by disorganized delusions and vivid hallucinations. show incoherence, disorganized behavior, disorganized delusions, hallucinations, and flat or inappropriate emotional responses. Extreme social impairment is common. People with this type of schizophrenia may also exhibit silliness and giddiness of mood, giggling, and nonsensical speech. They may neglect their appearance and personal hygiene and lose control of their bladder and bowels.

-Hallucinations & delusions
-Not systematized.
-Extreme withdrawal.
-Inappropriate affect.
-Bizarre behaviors.
-Poorest prognosis.
EX: homeless person who is pacing, mumbling.


Schizophrenic Disorders
-Catatonic Type

Catatonic schizophrenia is one of the most unusual psychological disorders. People with catatonic schizophrenia show striking impairment in motor activity. It is characterized by a slowing of activity into a stupor that may suddenly change into an agitated phase. Catatonic individuals may maintain unusual, sometimes difficult postures for hours, even as their limbs grow swollen or stiff. A striking feature of this condition is waxy flexibility, in which the person maintains positions into which he or she has been manipulated by others. Catatonic individuals may also show mutism, but afterward, they usually report that they heard what others were saying at the time.

-Catatonic stupor.
-Posture broken abruptly, pace & fidget.
-Sometimes hallucinations & delusions.


Schizophrenic Disorders
-Paranoid Type

A type of schizophrenia characterized primarily by delusions—commonly of persecution—and by vivid hallucinations.
-Delusions of grandeur & persecution.
-Hallucinations (usually auditory).
-Systematized (connected).
-Usually no inappropriate or flat affect.
-No catatonic or disorganized behavior.
-Best prognosis.


Schizophrenic Disorders
-Undifferentiated Type

Show abundant and varied symptoms that may be drawn from the major types.


Waxy Flexibility

A feature of catatonic schizophrenia in which people can be molded into postures that they maintain for quite some time.


Schizophrenic Disorders
-Biological Origins

-Genetic Vulnerability
-Over-utilization of Dopamine
-Enlarged Ventricles
-Deficiency in Gray Matter
-Viral Infections
-Birth Complications
*(also a sociocultural factor)


Schizophrenic Disorders
-Sociocultural Origins

-Poor Quality of Parenting
*(also a Psychological factor)
*(also a biological factor)


Schizophrenic Disorders
-Psychological Origins

-Family Discord
-Poor Quality of Parenting
*(also a sociocultural factor)


Personality Disorders

Making oneself or others miserable. Personality disorders, like personality traits, are characterized by enduring patterns of behavior. Personality disorders, however, are inflexible and maladaptive. They impair personal or social functioning and are a source of distress to the individual or to other people.


Personality Disorders
-Schizoid Personality Disorder

Characterized by indifference to relationships and flat emotional response. People with this disorder are “loners.” They do not develop warm, tender feelings for others. They have few friends and rarely maintain long-term relationships. Some people with schizoid personality disorder do very well on the job provided that continuous social interaction is not required. They do not have hallucinations or delusions. A personality disorder characterized by social withdrawal.


Personality Disorders
-Borderline personality disorder

People with borderline personality disorder show instability in their relationships, self-image, and mood and a lack of control over impulses. They tend to be uncertain of their values, goals, loyalties, careers, choices of friends, and sometimes even their sexual orientations. Instability in self-image or identity may leave them with feelings of emptiness and boredom. Many cannot tolerate being alone and make desperate attempts to avoid feelings of abandonment. They may be clinging and demanding in social relationships, and their clinging often pushes away the people on whom they depend. They alternate between extremes of adulation in their relationships (when their needs are met) and loathing (when they feel scorned). They tend to view other people as all good or all bad, shifting abruptly from one extreme to the other. As a result, they may flit from partner to partner in brief and stormy relationships. They tend to idealize people, then treat them with contempt when those people appear to have failed them.


Personality Disorders
-Antisocial Personality Disorder

People with antisocial personality disorder often show a superficial charm and are at least average in intelligence. They do not form meaningful bonds with other people, and they fail to learn to improve their behavior from punishment. Though they are often heavily punished by their parents and rejected by peers, they continue in their impulsive, careless styles of life. Whereas women are more likely than men to have anxiety and depressive disorders, antisocial personality disorder is more common among men. The diagnosis given a person who is in frequent conflict with society, yet who is undeterred by punishment and experiences little or no guilt and anxiety.


Personality Disorders

People with avoidant personality disorder are generally unwilling to enter a relationship without some assurance of acceptance because they fear rejection and criticism. As a result, they may have few close relationships outside their immediate families. Unlike people with schizoid personality disorder, however, they have some interest in, and feelings of warmth toward, other people.


Personality Disorders

Grandiose, self importance, need constant attention, and admiration. Entitlement, fantasies of unlimited success, lack empathy.



A perception that occurs in the absence of sensory stimulation and is confused with reality.