Psychological Disorders

• Psychological disorders are behavior patterns or mental processes that cause serious personal suffering or interfere with a person’s ability to cope with everyday life.

• Estimates suggest that almost one third of adults in the U.S. have experienced some type of psychological disorder.

• People with psychological disorders do not differ very much from people who are “normal”. The primary difference is the simple exaggeration of certain behaviors or mental process.

• Psychologists generally use several criteria to determine whether a person’s behavior indicates the presence of a psychological disorder:

• 1. Typicality – how normal is this behavior in society?

• 2. Maladaptivity – does the behavior impair an individual’s ability to function adequately in everyday life or is it hazardous to one’s health?

• 3. Emotional Discomfort – are there feelings such as hopelessness, helplessness, guilt, extreme sadness?

• 4. Socially Unacceptable Behavior – does the behavior violate society’s accepted norms?

• The importance of culture is demonstrated by culture-bound syndromes, clusters of symptoms that describe an illness.

• It is important to classify psychological disorders so that individuals can be correctly diagnosed and treated.

• The most widely used classification system for psychological disorders is the DSM, or Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association. The DSM-IV, published in 1994, recognized 18 different categories of psychological disorders.

• Until 1980, psychological disorders were classified on the basis of their presumed causes. (Most suggested by Freud’s psychoanalytic theory.) Many were grouped together under the labels “neuroses” and “psychoses”.

• Since 1980, they are categorized on the basis of observable signs and symptoms rather than presumed causes.

• Anxiety refers to a general state of dread or uneasiness that occurs in response to a vague or imagined danger.

• It is typically characterized by nervousness, inability to relax, and concern about losing control.

• Physical signs may include trembling, sweating, rapid heart rate, shortness of breath, increased blood pressure, flushed face, and feelings of faintness and light-headedness.

• Some people feel anxious all the time, or anxiety is out of proportion with what is causing it.

• When it interferes with effective living, the achievement of desired goals, life satisfaction, and emotional comfort, it is considered a sign of a psychological disorder.

• Types of Anxiety Disorders:

• 1. Phobic Disorder

• a. simple phobia – refers to a persistent, excessive or irrational fear of a particular object or situation.

• b. social phobia – characterized by persistent fear of social situations in which one might be exposed to the close scrutiny of others and thus be observed doing something embarrassing or humiliating.

• 2. Panic Disorder and Agoraphobia – People with panic disorders have recurring and unexpected panic attacks that may last from a few minutes to a few hours.

• Many who suffer from panic attacks also have agoraphobia and may be especially afraid of crowded public places such as movie theaters, shopping malls, buses, or trains.

• One or both of these disorders make up about 50 to 80 percent of the phobic individuals seen in clinical practice.

• 3. Generalized Anxiety Disorder – This is an excessive or unrealistic worry about life circumstances that lasts for at least six months. Typically, the worries focus on finances, work, interpersonal problems, accidents, or illness.

• GAD is one of most common disorders, but few people seek treatment because it does not differ, except in intensity and duration, from the “normal” anxiety of everyday life. Many people with GAD have other disorders as well, often phobias.

• 4. Obsessive-Compulsive Disorder – Obsessions are often senseless or repulsive, and most people with obsessions try to ignore or suppress them.

• People who experience obsessions are usually aware that the obsessions are unjustified. (Thus, they are not delusions.)

• Obsessions can make people feel extremely anxious, and they can seriously interfere with daily life.

• Compulsions may alleviate anxiety, but the compulsions themselves are time-consuming and usually create additional interference with daily life.

• 5. Stress Disorders – include post-traumatic stress disorder (PTSD) and acute stress disorder

• They have similar symptoms, but differ in how quickly they occur after the traumatic event that triggers the disorder and in how long they last.

• PTSD refers to intense, persistent feelings of anxiety that are caused by an experience so traumatic that it would produce stress in almost anyone.

• Symptoms include flashbacks, nightmares, avoidance of stimuli associated w/trauma, sleep disturbances, & irritability. They can occur six months or more after the traumatic event, and they last for years or even decades.

• Acute stress disorder is a short-term disorder with symptoms similar to those of PTSD. It also follows a traumatic event, but the symptoms occur immediately or at most, within a month of the event. The anxiety lasts a shorter time.

• Not everyone who experiences a trauma will develop one of these disorders.

• Dissociative Disorders

• Dissociative Amnesia – characterized by sudden loss of memory, usually following a particularly stressful or traumatic event. The person usually forgets any events that occurred for a certain period of time surrounding the traumatic event.

• Less commonly, the person may forget all prior experiences, even their name and family & friends. May persist for hours or years. Memory is likely to return just as suddenly as it was lost and it rarely recurs.

• Dissociative Fugue – characterized by not only forgetting personal information and past events, but also by suddenly relocating from home or work and taking on a new identity.

• It usually follows a traumatic event and when the fugue comes to an end, the person no longer remembers what happened during the fugue state.

• Dissociative Identity Disorder – involves the existence of two or more personalities within a single individual, usually due to severe childhood abuse or other types of trauma.

• The various personalities may or may not be aware of the others, and at least two of the personalities take turns controlling the individual’s behavior.

• Each personality is likely to be different from the others, including voice, facial expressions, and handedness, as well as self-perceived age, gender, and physical characteristics. The personalities may even have different allergies and eyeglass prescriptions.

• Depersonalization Disorder – refers to feelings of detachment from one’s mental processes or body. People feel “outside” of their bodies. It is a common symptom of other psychological disorders as well as being a disorder in its own right.

• SOMATOFORM DISORDERS

• Somatoform comes from the Greek word, soma, meaning body. Somatization is the expression of psychological distress through physical symptoms.

• People with somatoform disorders have psychological problems but experience inexplicable physical symptoms.

• They do not intentionally fake an illness (malingering), but honestly feel pain or believe they cannot move their limbs.

• 1. Conversion Disorder – People experience a change in or loss of physical functioning in a major part of the body for which there is no medical explanation.

• It is further complicated in many cases by the person’s little concern about the symptoms.

• 2. Hypochondriasis – Also called hypochondria, this is defined as a person’s unrealistic preoccupation with the fear that he or she has a serious disease.

• They become absorbed by minor physical symptoms and sensations, convinced that there is a serious medical illness.

• MOOD DISORDERS

• Major Depression – Major depression is diagnosed when an individual experiences at least five of the following nine symptoms (at least one has to be from the first two on the list):

• Persistent depressed mood for most of the day

• Loss of interest or pleasure in all, or almost all activities

• Significant weight loss or gain due to changes in appetite

• Sleeping more or less than usual

• Speeding up or slowing down of physical and emotional reactions

• Fatigue or loss of energy

• Feelings of worthlessness or unfounded guilt

• Reduced ability to concentrate or make meaningful decisions

• Recurrent thoughts of death or suicide

• Bipolar Disorder – characterized by ups and downs in mood. (manic depression) Periods of mania can change into depression very quickly and for no apparent reason.

• Manic moods can be characterized by elation or irritation. They can also have at least some of the following traits:

– Inflated self-esteem– Inability to sit still or sleep restfully– Pressure to keep talking and

switching from topic to topic– Racing thoughts – Difficulty concentrating

• People in the manic phase can experience delusions or hallucinations and can also engage in impulsive behaviors.

• SCHIZOPHRENIA

• This is usually considered the most serious psychological disorder and is characterized by a loss of contact with reality.

• It usually appears in early adulthood, but can be brought on at any age and becomes worse over time.

• The most obvious symptoms are hallucinations, delusions, and thought disorders. Most hallucinations are auditory.

• There may be delusions of grandeur or of persecution. Thought disorders involve problems in the organization or the content of mental processes.

• Thoughts can skip from topic to topic. People may repeat the same word over and over again, or invent new words. Some people may even go into a catatonic stupor.

• PERSONALITY DISORDER• These are patterns of inflexible

traits that disrupt social life or work and/or distress the affected individual. They usually show up late in adolescence and affect all aspects of the individual’s personality, including thought processes, emotions, and behavior.

• 1. Paranoid Personality Disorder – People with this tend to be distrustful and suspicious of others and to interpret others’ motives as harmful or evil. They are difficult to get along with and are usually considered argumentative, cold, and aloof. Their view of reality is distorted and they are unlikely to see their mistrust and suspicions as abnormal.

• 2. Schizoid Personality Disorder – People who suffer from this have no interest in relationships with other people and lack normal emotional responses. They stay in touch with reality (unlike schizophrenics), but do not develop attachments for other people.

• 3. Antisocial Personality Disorder – People with this show a persistent behavior pattern of disregarding and violating the rights of others. They do not feel guilt or remorse for their behaviors and continue despite the threat of punishment.

• 4. Avoidant Personality Disorder – These people desire relationships with others, but are hindered by tremendous fear of the disapproval of others. They are shy and withdrawn.