Chapter 14- Psychological Disorders
Anxiety Disorders- Anxiety is a familiar emotion to all of us- the feeling of tension,
apprehension, and worry that often hits during personal crisis and everyday conflicts.
In Anxiety Disorders, the anxiety is maladaptive (inhibit a person’s ability to adjust to
particular situations.) disrupting activities, moods, and thought processes. Three features
distinguish normal anxiety from pathological anxiety. Pathological anxiety is ; irrational,
uncontrollable, and disruptive.
Global, persistent, chronic and ongoing anxiety is the main
feature of GAD. Normal anxiety quickly dissipates when a
threatening situation is resolved. In GAD, when one source of
worry is removed, another quickly take it’s place. The anxiety
can be attached to any object or person or none at all. GAD is
often referred as “free-floating anxiety”.
Panic Disorder In panic disorder, the anxiety is sudden, intense and short-lived.
A Panic Attack is a sudden episode of extreme anxiety that
rapidly escalates in intensity. The most common symptoms of a
panic attack are a pounding heart, rapid breathing,
breathlessness, and a choking situation. When panic attacks
occur frequently and unexpectedly, the person is said to suffer
from panic disorder.
Phobias A phobia is a strong irrational fear of something, usually a
specific object or situation. Having a phobia does not mean a
person has a psychological disorder.
People with a Specific Phobia have an irrational fear of a
specific object or situation that interferes with the ability to
function in everyday life.
People with Social Phobia or Social Anxiety Disorder have an
extreme or irrational fear of being embarrassed, judged or
scrutinized in social situations. Social Phobia is far more
debilitating than everyday shyness. People with social phobia
are intensively fearful of being watched and judged by others.
Even in everyday activities, such as eating with friends in a
restaurant, can cause unbearable anxiety.
Phobias can partly be explained by; classical conditioning,
operant conditioning, and observational learning.
This is a type of phobia that deserves special attention.
Agoraphobia is an extreme and irrational fear of experiencing a
panic attack in a public situation and being unable to escape or
get help. Agoraphobia means “fear of the marketplace”.
Although agoraphobia and panic disorder are characterized
by panic attacks, not everyone with panic disorder develops
agoraphobia. Many people with agoraphobia will become
prisoners in their own homes, unable to go out the door.
PTSD is a long-lasting anxiety disorder that develops in
response to an extreme physical or psychological trauma.
Extreme traumas are events that produce intense feelings of
horror and helplessness, such as a serious physical injury or
threat of injury to yourself or to loved ones.
PTSD was originally associated with direct experiences of
military combat. However, it now know n that PTSD can
develop in survivors of other sorts of extreme traumas, such as
natural disasters, physical or sexual assault, random shooting
sprees, or terrorist attacks.
OCD is characterized by symptoms of anxiety which are
triggered by intrusive, repetitive thoughts and urges to perform
certain actions. A deficiency in the neurotransmitter serotonin
seems to be associated with OCD.
Obsessions are repeated, intrusive, uncontrollable thoughts or
mental images that cause a person great worry and distress. One
common obsession is an irrational fear of dirt, germs, and
other forms of contamination. Another common theme is the
pathological doubt about having accomplished a simple task,
such as shutting off appliances or locking a door.
Compulsions are repetitive behaviors that a person feels driven
to perform, Typically, compulsions are ritual behaviors that
must be carried out in a certain process or sequence.
Compulsions may be overt physical behaviors, such as repeated
hand washing, checking doors and windows. Other compulsions
may be covert mental behaviors, such as counting or reciting
certain phrases to yourself.
If a person tries to resist performing the ritual, unbearable
tension, anxiety and distress.
Many people with OCD have the irrational belief that failure to
perform the ritual action will lead to catastrophic or disastrous
Mood Disorders is a category of mental disorders in which significant and persistent disruptions
in mood or emotions cause impaired cognitive, behavioral, and physical functioning; also called
affective (affect is another word for “emotion or mood”) disorders. The DSM-IV-TR defines
mood disorder as a serious, persistent disturbance in a person’s emotions that cause
psychological discomfort which impairs the ability to function or both.
Major Depression Major Depressionis characterized by extreme and persistent
feelings of despondency, worthlessness, and hopelessness
causing impaired emotional, cognitive, behavioral, and physical
functioning. It is often triggered by traumatic and stressed
In Major Depression, there is a loss of pleasure in almost all
activities, feelings of emptiness, excessive guilt, preoccupation
with death or suicidal thoughts, difficulty sleeping, dimished
ability to think, concentrate or make decisions, and diminished
appetite and significant weight loss.
Dysthymic Disorder In contrast to major depression, which significantly impairs a
person’s ability to function, some people experience a less severe
form of depression called dysthymic disorder.
Dysthymic Disorder is chronic, low-grade depression. It is
characterized by many symptoms of depression, but the
symptoms are less intense. Although the person functions
adequately, they have a chronic case of “the blues” that can
continue for years.
Seasonal Affective Disorder
SAD is repeated episodes of depression in the changing seasons
of the onset of autumn to winter. In the most common form of
SAD, episodes of depression recur in the fall and winter months
when there is the least amount of sunlight.
Bipolar Disorder Bipolar Disorder involves periods of depression alternating
with periods of extreme euphoria and excitement (Mania). A
person with Bipolar Disorder experience extreme mood swings
During manic episodes, the person’s thoughts often rapidly shift
from topic to topic. This is often referred to as a “flight of
ideas”. For most people with Bipolar Disorders, a manic
episode immediately precedes or follows a bout with major
depression. However, according to the DSM-IV-TR , a small
percentage of people experience only manic episodes.
Cyclothymic Disorder Cyclothymic Disorder is characterized by moderate but
frequent mood swings, which last two years or more that are not
severe enough to qualify as bipolar disorder.
Personality Disorders are inflexible, maladaptive patterns of thoughts, emotions, behaviors, and
interpersonal functioning that are stable over time and across situations, and deviate from the
expectations of the individuals culture. Personality traits are consistent over time and across
situations, but they are not etched in stone. A psychologically well-adjusted person possesses a
fair degree of flexibility and adaptiveness. Based on our experiences with others, we are able to
modify are behaviors and how we display our personality traits. In contrast, someone with
personality disorder has personality traits that are inflexible and maladaptive across a broad
range of situations.
Paranoid Personality Disorder is characterized by pervasive
distrust and suspiciousness of the motives of other without
sufficient basis. About 3% of the general population display this
disorder, which occurs more frequently in men.
These individuals are constantly on guard because they think that
other people are out to exploit, harm, or dupe them.
Antisocial Personality Disorder is characterized by a pervasive
pattern of disregarding and violating the rights of others. These
people are often referred to as “psychopaths or sociopaths”.
These people have the ability to lie, steal, cheat, and otherwise
manipulate and harm other people. Evidence of this personality
trait can be seen in childhood or early adolescence. In many
cases, the child has repeated run-ins with the law or school
authorities. Behaviors that draw the attention of authorities can
include; cruelty to animals, attacking or harming adults or other
children, theft, setting fires, and destroying property. This pattern
of behavior is typically diagnosed as conduct disorder.
Borderline Personality Disorder is characterized by instability
of interpersonal relationships, self-image, and emotions, and
marked impulsivity. This is the most commonly diagnosed
personality disorder, of 10 million Americans diagnosed with
personality disorder, about 75% are women. The person has
extreme mood swings and angry outbursts are common. They
often have feelings of emptiness and are afraid of abandonment.
There sense of self is just as unstable and just as chaotic as their
external world, partly because their identity is so fragile.
Some researchers believe that a disruption in attachment
relationships in early childhood is an important cause.
Schizoid, Schizotypal, Histrionic, Narcissistic, Avoidant,
Dependent and Obsessive-Compulsive Personality Disorders.
Dissociative Disorders are a category of psychological disorders in which extreme and frequent
disruptions of awareness, memory, and personal identity impair and function. Dissociative
experience is one in which a person’s awareness, memory, and personal identity become
separated or divided. While that may sound weird, dissociative experiences are not inherently
pathological. Mild dissociative experiences are quite common and completely normal. In
Dissociative Disorders, the dissociative experiences are more extreme and frequent and severely
disruptive in everyday functioning.
Dissociative Amnesia Dissociative Amnesia refers to the partial or total inability to
recall important information that is not due to medical
conditions, such as illness, injury or drugs. Usually the person
develops amnesia for personal events and information, rather
than for knowledge or skills. In most cases, dissociative
amnesia is a response to stress, such as combat, marital
problems, or physical abuse.
Dissociative Fugue Dissociative Fugue is a closely related disorder to dissociative
amnesia. In dissociative fugue, the person outwardly appears
completely normal. However, the person has extensive amnesia
and is confused about his identity. While in the fugue state, they
suddenly and inexplicably travels from their home, wandering to
other cities or even countries. In some cases, people in a fugue
state adopt a completely new identity. It is thought to be
associated with traumatic events or stressful periods.
Dissociative Identity Disorder (DID) among all dissociative
disorders is more fascinating- or controversial than any other,
formerly known as multiple personality disorder. It involves
extensive memory disruptions for personal information with the
presence of two or more distinct identities or “personalities”
within a single person. Typically, each personality has its own
name and is experienced as if it has its own history and self-
image. These alternate personalities are often called alters or
alter egos, each of which may have different ages and genders.
In order to explain dissociative identity disorder, research has
shown that a very high percentage of DID patients report having
suffered extreme physical or sexual abuse in childhood- over
90% in most surveys.
Schizophrenia according to the DSM-IV-TR is a disorder characterized by impaired functioning
by severely distorted beliefs, perceptions, and thought processes.
Schizophrenia Schizophrenia can be described in terms of two broad
categories: positive and negative symptoms. Schizophrenia is
an extremely complex disorder also called psychosis, which is a
characterized by a loss of contact with reality. There are
enormous individual variability in the onset, symptoms, duration,
and recovery from schizophrenia. According to the dopamine
hypothesis, schizophrenia is related to excessive activity of the
neurotransmitter dopamine in the brain. There is also strong
evidence that shows there is genetic involvement .
Positive Symptoms of
Delusions are false beliefs that persists in spite of contradictory
evidence. Delusions of Reference occur when a person
convinced that other people are constantly talking about them
and everything that is related to them in some way. They believe
the person on the radio is speaking to them. Delusions of
Grandeur are when a person believes they are extremely
powerful, wealthy, or important. They believe they are the
president of the United States or Jesus. Delusions of
Persecution are when a person believes other people are plotting
against them to harm them or someone important to them. A
person may believe that “terrorist forces” are going to attack
them in their own home.
Hallucinations are false or distorted perceptions that seem
vividly real. The content of hallucinations is often tied to the
person’s delusional beliefs. Hallucinations include; visual,
smell or taste, touch or tactile and the most common type of
hallucination which is auditory.
Negative Symptoms of
Negative Symptoms of Schizophrenia include; social
withdrawal, loss of motivation, very limited speech, slowed
movements, poor hygiene, poor problem-solving abilities and a
distorted sense of time. Some people may exhibit a flat affect,
showing practically no emotional response at all, even though
they may report feeling emotional.
Four Types of
Paranoid Schizophrenia is the most common type of
schizophrenia with symptoms of delusions and hallucinations.
Disorganized Schizophrenia is the most serious type marked by
extreme social withdrawal, hallucinations, delusions and
Catatonic Schizophrenia is characterized by bizarre postures or
grimacing or echoing words spoken by another person.
Undifferentiated Schizophrenia is when the symptoms do not
conform to one type of schizophrenia.
Chapter 15- Therapies
Psychoanalytic Therapy Psychoanalytic Therapy or Psychoanalysis is a form of
therapy developed by Sigmund Freud.
Psychotherapy can be described as the use of psychological
techniques to increase understanding and treat emotional,
behavioral and interpersonal problems. All forms of
psychotherapy share the assumption that psychological factors
play a significant role in problematic emotions, behaviors and
Psychoanalysis is a form of therapy based on dream
interpretation, transference and resistance.
Transference refers to a patient responding to the therapist as
though the therapist was a significant person in their life.
Resistance refers to patients unconscious attempts to block
repressed memories and conflicts.
Humanistic Therapy –
Client- centered therapy
The humanistic perspective has exerted a strong influence on
psychotherapy. The most influential of the humanistic
psychotherapies is client-centered therapy, also called person-
centered therapy developed by Carl Rogers.
Carl Rogers believed to promote self-awareness, psychological
growth and self-directed change the three qualities important of a
therapist are e; genuineness, unconditional positive regard and
Behavior Therapy Behavior therapy, also called Behavior Modification is to
modify a specific problem behavior, not to change the entire
personality. Behavior therapy use techniques of learning and
conditioning to change behavior.
Mary Cover Jones was the first behavior therapist who
developed was the first behavior therapist who developed
counterconditioning- the learning of a new response that is
incompatible with a previously learned response.
Cognitive Therapy Cognitive therapies is based on the assumption that
psychological problems are due to maladaptive patterns of
thinking, treatment techniques focus on recognizing and altering
these unhealthy thinking patterns.
Albert Ellis developed rational-emotional therapy (RET)
which promotes psychologically healthier thought process by
disputing irrational beliefs and replacing them with more rational
interpretations of events. “ABC” Model- (A) Activating Event
(B) Beliefs and (C) Consequences
Cognitive-Behavioral Therapy (CBT) integrates cognitive and
behavioral techniques and based on the assumption that
thoughts, moods, and behaviors are interrelated.