Week 14 Presentation

Chapter 14: Psychological Disorders

Chapter 14 Overview: Big Questions
• What Is a Psychological Disorder?
• How Do People Experience Disorders of Emotion?
• How Do People Experience Disorders of Thought?
• How Do People Experience Disorders of Self?
• What Disorders Affect Children?

Chapter 14 Overview: Study Units
• 14.1 Disorders Interfere with Our Lives
• 14.2 There Are Two General Ways to View the Causes of Disorders
• 14.3 Disordered Thoughts, Emotions, and/or Behaviors Can Be Assessed and Categorized
• 14.4 Anxiety Disorders Make People Fearful and Tense
• 14.5 Some Disorders Have Unwanted and Intrusive Thoughts That Increase Anxiety
• 14.6 Depressive Disorders Consist of Sad, Empty, or Irritable Mood
• 14.7 Many Factors Influence the Development of Depressive Disorders
• 14.8 Bipolar Disorders Involve Mania
• 14.9 Schizophrenia Involves a Disconnection from Reality
• 14.10 Schizophrenia Is Caused by Biological and Environmental Factors
• 14.11 Personality Disorders Are Maladaptive Ways of Relating to the World
• 14.12 Dissociative Disorders Involve Disruptions in the Sense of Self
• 14.13 Children May Experience Neurodevelopmental Disorders
• 14.14 Autism Spectrum Disorder Involves Social Deficits and Restricted Interests
• 14.15 Attention-Deficit/Hyperactivity Disorder Is a Disruptive Impulse Control Disorder

What Is a Psychological Disorder?
14.1 Disorders Interfere with Our Lives
14.2 There Are Two General Ways to View the Causes of Disorders
14.3 Disordered Thoughts, Emotions, and/or Behaviors Can Be Assessed and Categorized

14.1 Disorders Interfere with Our Lives (1)
Psychopathology: Sickness or
disorder of the mind.
• Drawing the line between
“normal” emotions, thoughts,
and behaviors and
a psychological disorder can
be difficult.
• When a psychological problem
disrupts a person’s life and
causes significant distress over a
long period, the problem is
considered a disorder.

To fully understand any disorder, psychologists need to
investigate it from four perspectives:
1. Identify the etiology—the factors that contribute
to the development of a disorder.
2. Assess the symptoms.
3. Group symptoms into meaningful categories
to make a diagnosis.
4. Identify possible treatments.

14.2 There Are Two General Ways to View the Causes of Disorders (1)
The Diathesis-stress model
• Proposes that a disorder may
develop when an underlying
vulnerability is coupled with
a precipitating event
o According to this model, the
onset of mental disorders
occurs due to both vulnerability
for the disorder and the
presence of stressful events.

The biopsychosocial approach states that most
psychological disorders are influenced by biological,
psychological, and sociocultural factors.
• The biological aspect of this approach focuses on how
physiological factors, such as brain
function, neurotransmitter imbalances, and
genetics, contribute to psychological disorders.
• The psychological aspect of the approach states that
thoughts, emotions, personality, and learned
experiences all influence the development of
psychological disorders.
• Sociocultural factors include family relationships,
socioeconomic status, and the cultural context.

14.3 Disordered Thoughts, Emotions, and/or Behaviors Can
Be Assessed and Categorized (1)
• Assessment of a person’s mental functions and
actions allows psychologists to
o Categorize the individual’s thoughts, emotions,
and behaviors in order to make a diagnosis so
that appropriate treatment can be provided
o Understand the course of the condition and its
probable outcome, or prognosis

Assessing symptoms
• The first step in an assessment
is often to conduct an interview.
• People’s self-reports can reveal a
great deal.
• A psychological assessor can
also gain information through
observation of the client’s
behavior.
• Another source of information
regarding psychopathology is
psychological testing.

Categorizing disordered thoughts and
behavior
• In ancient times, madness was
believed to be caused by the gods,
witches, or some sort of evil spirits.
• The idea of categorizing mental
disorders systematically was not
officially adopted until 1952, when
the American Psychiatric
Association published the first
edition of the Diagnostic and
Statistical Manual of Mental
Disorders (DSM).

14.3 Disordered Thoughts, Emotions, and/or Behavior Can Be
Assessed and Categorized (5)
• In the current edition of the Diagnostic and Statistical Manual, DSM-
5 (released in 2013), disorders are described in terms of observable
symptoms.
• A person must meet specific criteria to receive a particular
diagnosis.
• The DSM-5 consists of three sections:
1. An introduction with instructions for using the manual
2. Diagnostic criteria for all the disorders, which are grouped so
that similar disorders are located near each other
3. A guide for future psychopathology research that describes
conditions not yet officially recognized as disorders
• The dimensional approach considers mental disorders along a
continuum on which people vary in degree rather than in kind.

Categorizing disordered thoughts and
behavior
• Many mental disorders may occur
together even though the DSM-
5 treats them as separate
disorders—for example,
depression and anxiety, or
depression and substance abuse.
This state is known as comorbidity.
• DSM-5 describes 19 major
categories of disorder, each of
which has several variations or
types.

How Do People Experience Disorders of
Emotion?
14.4 Anxiety Disorders Make People Fearful and Tense
14.5 Some Disorders Have Unwanted and Intrusive Thoughts that Increase Anxiety
14.6 Depressive Disorders Consist of Sad, Empty, or Irritable Mood
14.7 Many Factors Influence the Development of Depressive Disorders
14.8 Bipolar Disorders Involve Mania

14.4 Anxiety Disorders Make People Fearful and Tense (1)
Anxiety disorders are characterized
by excessive anxiety in the absence
of true danger.
• People who experience anxiety
disorders feel anxious, tense,
and worried about the future.
o By continually arousing the
autonomic nervous system,
chronic anxiety also causes
bodily symptoms such as
sweating, dry mouth,
rapid pulse, shallow
breathing, and increased
muscular tension.

Symptoms of specific phobia
• Fear of a specific object or
situation that is out of
proportion with an actual
threat
• Affects about 1 in 8
people; involves
particular objects and
situations

• Symptoms of social anxiety disorder (also called social
phobia)
o Fear of being negatively evaluated by others
o Affects about 1 in 14 people
• Symptoms of generalized anxiety disorder
o A diffuse state of constant anxiety not associated
with any specific object or event
o People with this disorder are constantly
anxious and worry incessantly about even minor
matters.

Symptoms of panic disorder
• An anxiety disorder that consists of sudden,
overwhelming attacks of terror
Symptoms of agoraphobia
• An anxiety disorder marked by fear of being
in situations from which escape may be difficult or
impossible
o People who experience agoraphobia avoid going into
open spaces or to places that might have crowds.

Development of anxiety disorders
• Although people are anxious about different things,
the etiology of various types of anxiety is best
explained using a biopsychosocial approach.
• We also know that many fears are learned.

14.5 Some Disorders Have Unwanted and Intrusive Thoughts
That Increase Anxiety (1)
Symptoms of obsessive-compulsive disorder (OCD)
• OCD is a disorder characterized by frequent intrusive thoughts
that create anxiety and compulsive actions that temporarily
reduce the anxiety.
o Affecting 1–2 percent of the population, OCD is more common in
women than men and generally begins in early adulthood.
• Obsessions are recurrent, intrusive, and unwanted thoughts, urges,
or mental images.
o They often include intense worry and fears of contamination, of
accidents, or of one’s own aggression.
• Compulsions are particular acts that the person feels driven to
perform over and over again.
o The most common compulsive behaviors are cleaning, checking,
and counting.

Development of obsessive-compulsive
disorder
• OCD is another example of how
the biopsychosocial approach
explains the causes of some
mental disorders.
o There is also good evidence
that the etiology of OCD is
in part biological—
specifically, genetic—in
nature.
o Brain imaging has also
provided some evidence
regarding which brain
systems are involved in OCD.

Symptoms of posttraumatic stress disorder
• Trauma and stressor-related disorders
o Posttraumatic stress disorder (PTSD): A
mental disorder that involves frequent nightmares,
intrusive thoughts, and flashbacks related to an
earlier trauma.
 Around 7 percent of the population will experience
PTSD at some point, and women are more likely to
develop the disorder.
• Adjustment disorder
o People have difficulty adjusting to stressors.

14.6 Depressive Disorders Consist of Sad, Empty, or Irritable
Mood (1)
Depressive disorders are a type of mood disorder
featuring persistent and pervasive feelings of sadness.

Mood (2)
Symptoms of major depressive disorders
• Major depressive disorder: Mood disorder, characterized by
extremely depressed moods or a loss of interest in normally
pleasurable activities, that persists for two weeks or more.
o Affects about 7–8 percent of Americans in any given year,
and approximately 16 percent of Americans will experience
major depression at some point in their lives.
• Persistent depressive disorder: Mood disorder, characterized by
mildly or moderately depressed moods, that persists for at least
two years.
o People with persistent depressive disorder—approximately 2–3
percent of the population—may have many of the same symptoms
as those with major depression, but the symptoms are less intense.

Mood (3)

Mood (4)

14.7 Many Factors Influence the Development of Depressive
Disorders (1)
Biological factors in depressive disorders
• Biopsychosocial factors play a role in the etiology of
depression.
o Studies of twins, of families, and of
adoptive children support the notion that
depression has a genetic component.
o Studies of brain function have suggested
that certain neural structures may be involved in
mood disorders.

Disorders (2)
Psychological factors in depressive disorders
• Aaron Beck has hypothesized that a psychological factor
associated with depression is how people think of themselves.
• From Beck’s perspective, people likely to develop depression
blame misfortunes on personal defects and see
positive occurrences as the result of luck.
o Cognitive triad
• A second cognitive theory of depression is based on learned
helplessness.
o People come to see themselves as unable to have any effect
on events in their lives.

Disorders (3)

Disorders (4)
Social factors in depressive disorders
• Across multiple countries and contexts, twice as
many women as men are diagnosed
with depression.
o One theory is that women respond to
stressful events by internalizing their feelings,
which leads to depression and anxiety, whereas
men externalize their feelings with alcohol,
drugs, and violence (Holden, 2005).

14.8 Bipolar Disorders Involve Mania (1)
Symptoms of bipolar disorder
• Bipolar I disorder: Mood
disorder characterized by
extremely elevated
moods during manic
episodes.
• Bipolar II disorder: Mood
disorder characterized by
alternating periods
of extremely depressed and
mildly elevated moods.

A case study of bipolar disorder
• Psychology professor Kay
Redfield Jamison acknowledged
her own struggles with bipolar
disorder in her award-winning
memoir An Unquiet Mind.
• Major artists and writers who
may have had bipolar disorders
include
o Michelangelo
o Vincent van Gogh
o Georgia O’Keeffe
o Ernest Hemingway

Development of bipolar disorders
• Bipolar disorders are much less common than depression.
o Around 3–4 percent of the population will experience a
bipolar disorder in their lifetimes.
• Bipolar disorders are equally prevalent in women and men.
• Bipolar disorders emerge most commonly during late
adolescence or early adulthood.
• There is a very strong genetic component to bipolar disorders.
o Genetic research also suggests, however, that
the hereditary nature of bipolar disorders is complex and
not linked to only one gene.

Thought?
14.9 Schizophrenia Involves a Disconnection from Reality
14.10 Schizophrenia is Caused by Biological and Environmental Factors

14.9 Schizophrenia Involves a Disconnection from Reality (1)
Schizophrenia: A psychological disorder characterized by extreme
alterations thought, in perceptions, and /or in consciousness,
resulting in a break from reality, so the person experiences psychosis.
• Around 1 in 200 persons around the globe have shizhophrenia.
• The rates for men and women are similar.
• Schizophrenia is characterized by a combination of motor,
cognitive, behavioral, and perceptual abnormalities.
• These abnormalities result in impaired social, personal, or
vocational functioning or in some combination of these
impairments.
• To be diagnosed with schizophrenia, a person has to have shown
continuous signs of disturbances for at least 6 months.

There are five major DSM-5 symptoms for schizophrenia:
1. Delusions
2. Hallucinations
3. Disorganized speech
4. Disorganized behavior
5. Negative symptoms
A diagnosis of schizophrenia requires a person to show two
or more of these symptoms, including at least one of the
first three symptoms listed.

Researchers tend to group the five symptoms of
schizophrenia into two categories:
• Positive symptoms: Symptoms of schizophrenia
that are marked by excesses in functioning, such as
delusions, hallucinations, and disorganized speech
or behavior.
• Negative symptoms: Symptoms of schizophrenia
that are marked by deficits in functioning, such as
apathy, lack of emotion, and slowed speech and
movement.

Positive symptoms of schizophrenia
• Delusions
o False beliefs based on incorrect inferences about
reality
• Hallucinations
o False sensory perceptions that are experienced
without an external source
 Hallucinations are frequently auditory but can
also be visual, olfactory, or bodily.

Disorganized speech
• Speaking in an incoherent way that involves frequently
changing topics and saying strange or inappropriate
things
o Loosening of associations
o Clang associations
Disorganized behavior
• Acting in strange or unusual ways, including strange
movement of limbs and inappropriate self-care, such as
failing to dress properly or bathe

Negative symptoms
• About 1 in 4 people with schizophrenia show reductions in typical
behavior, which are called negative symptoms.
• People with schizophrenia often avoid eye contact and seem apathetic.
• They may not express emotion.
• Their speech may be slowed.
• They may use a monotonous tone of voice.
• They may take long pauses before answering.
• They may fail to respond to a question or be unable to complete their
sentences.
• Negative symptoms are more common in men.

14.10 Schizophrenia Is Caused by Biological and
Environmental Factors (1)
Biological factors affect the development of schizophrenia.
• The etiology of schizophrenia is not well understood.
o Schizophrenia runs in families, and genetics clearly plays a
role in the development of the disorder.
 Twin studies
o Schizophrenia is primarily a brain disorder.
 One possibility is that schizophrenia results from an
abnormality in neurotransmitters.
o Schizophrenia is most often diagnosed when people are in
their 20s or 30s.

Environmental factors affect the development of
schizophrenia
• For people who are genetically at risk
for schizophrenia, environmental stress seems
to contribute to its development.
o This finding is consistent with the diathesis-
stress model.
o Researchers have also theorized that
the increased stress of urban environments can
trigger the onset of the disorder.

Self?
14.11 Personality Disorders Are Maladaptive Ways of Relating to the World
14.12 Dissociative Disorders Involve Disruptions in the Sense of Self

14.11 Personality Disorders Are Maladaptive Ways of
Relating to the World (1)
Some people’s identities
cause them to interact with
the world in maladaptive
and inflexible ways.
• When this style of
interaction is long-
lasting and causes
problems in work and
social situations, it
becomes a personality
disorder.

Symptoms and development of borderline personality
disorder
• A personality disorder characterized by disturbances in
identity, in moods, and in impulse control
o 1–2 percent of adults meet the criteria for borderline
personality disorder.
o Borderline personality disorder may have an
environmental component because of the strong
relationship that exists between the disorder and
trauma or abuse.

Symptoms and development
of antisocial personality disorder (APD)
• A personality disorder marked by disregard
for and violation of the rights of others and
by lack of remorse
o Psychopaths: Ironically, people with
psychopathic traits are often seen as
charming and intelligent.
o In the United States, about 1–4 percent of the
population has APD.
o Various physiological abnormalities may play
a role in the disorder.

14.12 Dissociative Disorders Involve Disruptions in the Sense of
Self (1)
Dissociative disorders involve disruptions of
• Identity
• Memory
• Conscious awareness

Self (2)
Symptoms and development of dissociative amnesia
• Psychological disorder that involves disruptions
of memory for personal facts or loss of conscious
awareness for a period of time
o The rarest and most extreme form of
dissociative amnesia is dissociative fugue, which
involves traveling to another location (the Latin
word fuga means “flight”) and sometimes
assuming a new identity.

Self (3)
Symptoms and development of
dissociative identity disorder
(DID)
• The occurrence of two or more
distinct identities in the same
individual
• The condition was formerly
called multiple personality
disorder (MPD).
• Most people diagnosed with
DID are women who report
being severely abused as
children.

What Disorders Affect Children?
14.13 Children May Experience Neurodevelopmental Disorders
14.14 Autism Spectrum Disorder Involves Social Deficits and Restricted Interests

14.13 Children May Experience Neurodevelopmental Disorders
All the
neurodevelopmental
disorders should be
considered within the
context of normal
childhood development.
• This category includes
a wide range
of disorders.

14.14 Autism Spectrum Disorder Involves Social Deficits and
Restricted Interests (1)
Autism spectrum disorder: A developmental disorder
characterized by deficits in social interaction, by
impaired communication, and by restricted, repetitive behavior and
interests
• Approximately 1–2 percent of children show signs of autism
spectrum disorder, and males with the disorder outnumber
females 5 to 1.
• From 1991 to 1997, there was a dramatic increase (of 556
percent) in the number of children diagnosed with autism.
• Autism spectrum disorder varies in severity, from mild social
impairments to severe social and intellectual impairments.
• High-functioning autism is sometimes called Asperger’s syndrome.

Symptoms of autism spectrum disorder
• Children with a severe form of autism spectrum disorder are
seemingly unaware of others.
• Deficits in communication are another characteristic of autism
spectrum disorder.
• Another set of deficits includes restricted, repetitive behaviors and
interests.
• Any changes in daily routine or in the placement of furniture or toys
are very upsetting for children with autism spectrum disorder.
• Their behavior also tend to be repetitive and can include strange hand
movements, body rocking, and hand flapping.
• Self-injury is common, and some children must be forcibly restrained
to keep them from hurting themselves.

Development of autism spectrum disorder
• It is now well established that autism is the result of
biological factors.
o Research into the causes of autism also points
to prenatal and/or early childhood events that
may result in brain dysfunction.
o There is evidence that the brains of people
with autism have faulty wiring in a large number
of areas.

14.15 Attention-Deficit/Hyperactivity Disorder Is a Disruptive
Impulse Control Disorder (1)
Symptoms of attention-
deficit/hyperactivity disorder
(ADHD)
• A disorder characterized by
excessive activity or fidgeting,
inattentiveness, and impulsivity
o Children must show
symptoms before age 12 to
be diagnosed with ADHD.
o In the United States, 7
percent of children have
ADHD, and it is more
common in boys than girls.

Development of ADHD
• The causes of ADHD are unknown.
o Possible factors such as poor parenting and
social disadvantage may contribute to the onset
of symptoms.
o Researchers have theorized that the
connection between the frontal lobes and the
limbic system is impaired in ADHD patients.

ADHD across the life span
• First diagnosed between ages 5 and 7
o With the development of more structured day
care settings, the demands on children to
conform are occurring much earlier.
• The DSM-5 recognizes that many of the symptoms
of ADHD continue well into adulthood.
o Adults with ADHD symptoms compose about
4 percent of the population.

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