Module 46
Defining Psychological Disorders

abnormal psychology
Applying psychological science to our understanding and treatment of psychological disorder. About 1 in every 4 Americans (or over 78 million people) are affected by a psychological disorder during any one year, [4] and at least a half billion people are affected worldwide. The impact of mental illness is particularly strong on people who are poorer, of lower socioeconomic class, and from disadvantaged ethnic groups

the frequency of occurrence of a given condition in a population at a given time

psychological disorder
An ongoing dysfunctional pattern of thought, emotion, and behavior that causes significant distress, considered deviant in that person’s culture or society. Have much in common with other medical disorders. Out of the patient’s control, in some cases are treated by drugs, their treatment is often covered by medical insurance. Like medical problems, have both biological (nature) as well as environmental (nurture) influences. These causal influences are reflected in the bio-psycho-social model of illness. Social-Cultural Influences, Biological Influences, Psychological influences

bio-psycho-social model of illness
a way of understanding disorder that assumes that disorders are caused by biological, psychological, and social factors

biological component
the influences on disorder that come from the functioning of the individual’s body

psychological component
If the bio-psycho-social model refers to the influences that come from the individual, such as patterns of negative thinking and stress responses.

social component
the bio-psycho-social model refers to the influences on disorder due to social and cultural factors such as socioeconomic status, homelessness, abuse, and discrimination.

Psychological Influences
Poor coping, pessimistic thinking, pattern of interpreting neutral events as negative, responses to stress

Social-cultural Influences
Pattern of negative relationships with other people
Cultural Expectations
Stigma and prejudice
Gender roles
Socio-economic status
Definitions of normality and disorder

Biological Influences
Brain Structure
Imbalance of the neurotransmitter, Serotonin
Abnormality within the brain

occurs when people who suffer from one disorder also suffer at the same time from other disorders. Because many psychological disorders are comorbid, most severe mental disorders are concentrated in a small group of people (about 6% of the population) who have more than three of them.

stigma of phycological disorder
a disgrace or defect that indicates that person belongs to a culturally devalued social group. . In some cases the stigma of mental illness is accompanied by the use of disrespectful and dehumanizing labels, including names such as “crazy,” “nuts,” “mental,” “schizo,” and “retard.”

Media portrayals of mental illness lead to
slowed down recovery

Society’s attitudes towards mental illness leads to
employment discrimination

Disrespectful labels, like “crazy” or “schizo”

Diagnostic and Statistical Manual of Mental Disorders (DSM)
an ever revised handbook that clearly and concisely provides standard criteria for the classification of mental disorders. Used by therapists, researchers, drug companies, health insurance companies and policymakers in the United States and other countries to help determine appropriate services and treatment for a person suffering from a mental disorder.
published in 1952
revised five times

In the DSM-5, The role of Type 1 Diabetes is
documented right along with a clinical disorder and any presence of a personality disorder

Diagnosis of Depressive Disorder is documented
along with any existing personality and/or medical illnesses

The purpose of the DSM-5 is to provide
descriptions of the symptoms associated with categories of disorders

When using the DSM-5 for complete diagnostic purposes
multiple types of information are gathered on a patient

If a psychologist wants to determine whether a person has a mental disorder, she will usually determine if the individual’s behavior causes both
distress and dysfunction

Distress refers to whether a behavior
is upsetting to the individual

In the bio-psycho-social model of mental disorder, negative thought patterns would be a ______ influence.

Jerry has a genetic predisposition towards depression. According to the bio-psycho-social model of mental disorder, his likelihood of developing depression is __________________.
conditional; he may or may not develop depression depending on the psychological and socio-cultural influences in his life

A psychologist using the DSM to help diagnose a client will use what approach?
The psychologist will look at symptoms, such as depression and anxiety, personality factors, medical condition, problems at home or at work, as well as general functioning to diagnose the disorder.

The percent of persons with a particular diagnosis is called _________.

Comorbidity refers to
an individual having two diagnoses at the same time, such as anxiety and depression

Being rejected from society because of mental illness is the result of _________.

Consequences of stigma for people with mental illness
Failure to seek treatment
Decreased self esteem

Module 47
Anxiety Disorders

the nervousness or agitation that we sometimes experience, often about something that is going to happen, is a natural part of life.

anxiety disorders
psychological disturbances marked by irrational fears, often of everyday objects and situations.

generalized anxiety disorder (GAD)
diagnosed when a person has been excessively worrying about money, health, work, family life and/or relationships for at least 6 months and when the anxiety causes significant distress and dysfunction

panic disorder
a psychological disorder characterized by sudden and recurrent panic attacks that reaches a peak within minutes

(from the Greek word phobos, which means “fear”) is a specific fear of a certain object, situation, or activity.

Social Anxiety Disorder
Extreme fear or anxiety about at least one social situation, having a conversation, meeting unfamiliar people, where the affected person feels at risk for scrutiny by others. May be specific event, such as speaking in public or using a public restroom, or it can be a more generalized anxiety toward almost all people outside of close family and friends.

most incapacitating phobia; marked fear or anxiety about at least two types of situations. Fear of situations in which escape is difficult

Obsessive-compulsive disorder (OCD)
psychological disorder that is diagnosed when an individual continuously experiences obsessions (distressing, intrusive, or frightening thoughts), and engages in compulsions (repetitive behaviors or mental acts) in an attempt to calm these obsessions.

A short (up to 20 minute) period of time characterized by intense anxiety is known as a(n):
panic attack

The defining feature of Generalized Anxiety Disorder is:
excessive worry

An obsession is a(n):
distressing and/or unwanted thought

A fear of situations where escape is difficult, often related to panic attacks is known as:

Brandon has nightmares and flashbacks of a bad car accident he was in a few months ago. He is most likely experiencing:

The fact that we fear things that are actually harmful has been proposed as an evolutionary explanation for:

A person with a genetic predisposition towards anxiety may or may not develop an Anxiety Disorder. This points to the importance of:
environmental factors

Module 48
Mood Disorders

the positive or negative feelings that are in the background of our everyday experiences

Mood (or affective) disorders
Person’s mood negatively influences his or her physical, perceptual, social, and cognitive processes. People who suffer from mood disorders tend to experience more intense (and particularly more intense negative) moods. About 10% of the U.S. population suffers from a mood disorder in a given year.

a condition characterized by mild, but chronic, depressive symptoms that last for at least 2 years.

Major depressive disorder (clinical depression)
An all-encompassing low mood accompanied by low self-esteem and by loss of interest or pleasure in enjoyable activities. In some cases people lose contact with reality and may receive a diagnosis with psychotic features. In these cases depression includes delusions and hallucinations.

Symptoms of Depression
clinical depression is a extreme version of normal sadness; sad mood, lack of interest in activities, inability to concentrate, insomnia, irrability, Loss of interest in personal appearance, Feelings of hopelessness, Changes in appetite

bipolar disorder
Swings in mood from overly “high” to sad and hopeless, and back again, with periods of near-normal mood in between. Experiences with depression are followed by a more normal period and then a period of mania or euphoria in which the person feels particularly awake, alive, excited, and involved in everyday activities but is also impulsive, agitated, and distracted

the process of generating new neurons; Antidepressant drugs may alleviate depression in part by increasing neurogenesis

selective serotonin reuptake inhibitors (SSRIs)
The researchers focused on this gene because serotonin is known to be important in depression; have been shown to be effective in treating depression

Results From Caspi et al., 2003
This important study provides an excellent example of how genes and environment work together: An individual’s response to environmental stress was influenced by his or her genetic makeup.

Studies examining the genetic predisposition of some people to depression have focused on the neurotransmitter

Which of the following is a psychological cause of depression?
negative cognitions

Prahlad has experienced mild, ongoing sadness and loss of interest for the past few years. Prahlad is most likely to be diagnosed with __________.

Which alternative best expresses the relationship between dysthymia and depression?
-Dysthymia involves a loss of contact with reality; depression does not.
-Dysthymia is unrelated to depression.
-Dysthymia is more severe than depression.
-Dysthymia is less severe than depression.
Dysthymia is less severe than depression.

Butch alternates between periods of dark despair and times of elation, great energy, recklessness, and creativity. Butch suffers from __________.
bipolar disorder

Caspi and his colleagues found that people with the “short” version of the 5-HTT gene were more influenced by stressors than were people without the short version of the gene. This study shows an interaction between which two components of the bio-psycho-social model of illness?
Biological and social

Each of the following neurotransmitters seems to play a role in depression except __________.

Neurotransmitters that play a role in depression
Norepinephrine, Serotonin, Dopamine

Module 49

a serious psychological disorder marked by delusions, hallucinations, loss of contact with reality, inappropriate affect, disorganized speech, social withdrawal, and deterioration of adaptive behavior.

a psychological condition characterized by a loss of contact with reality.

false sensations that occur in the absence of a real stimulus or which are gross distortions of a real stimulus;
*sensory perceptions in the absence of any external stimulus

false beliefs not commonly shared by others within one’s culture, and maintained even though they are obviously out of touch with reality.
*false beliefs that are held strongly, despite evidence that they are false

delusions of grandeur
believe that they are important, famous, or powerful; Some claim to have been assigned to a special covert mission.

delusions of persecution
believe that a person or group seeks to harm them. They may think that people are able to read their minds and control their thoughts

the shifting from one subject to another, without following any one line of thought to conclusion

grossly disorganized behavior
including inappropriate sexual behavior, peculiar appearance and dress, unusual agitation (e.g., shouting and swearing), strange body movements, and awkward facial expressions;
-behaving in a inappropriate, strange, or silly way

inappropriate affect
the person may laugh uncontrollably when hearing sad news. Movement disorders typically appear as agitated movements, such as repeating a certain motion again and again

a state in which a person does not move and is unresponsive to others

Negative symptoms of schizophrenia
refer to the loss or deterioration of thoughts and behaviors that are typical of normal functioning
ex; social withdrawal, poor hygiene and grooming, poor problem-solving abilities, and a distorted sense of time, tendency toward incoherent language; flat effect,

flat affect
means that they express almost no emotional response (e.g., they speak in a monotone and have a blank facial expression) even though they may report feeling emotions.
-little or no display of emotion

Cognitive symptoms of Schizophrenia
difficulty comprehending information and using it to make decisions (the lack of executive control), difficulty maintaining focus and attention, and problems with working memory (the ability to use information immediately after it is learned).

Positive symptoms of Schizophrenia
the presence of abnormal behaviors or experiences (such as hallucinations) that are not observed in normal people; delusions

Many researchers believe that schizophrenia is caused in part by
excess dopamine, and this theory is supported by the fact that most of the drugs useful in treating schizophrenia inhibit dopamine activity in the brain.

Neuroimaging studies show that patients with schizophrenia often have enlarged

Based on the effectiveness of drugs used to treat schizophrenia, researchers believe that the neurotransmitter __________ has a primary role in the disease.

Someone with an identical (MZ) twin who has schizophrenia has what percent chance of having the disease?

whereas someone with a fraternal (DZ) twin who has schizophrenia has what percent chance of having the disease?

relationship between stress and schizophrenia
people with schizophrenia may be less resistant to stress
stress can bring about more severe symptoms in people with schizophrenia
stress can bring about the first signs of symptoms in people with schizophrenia

Mr. Wallace has schizophrenia. He appears motionless for long periods and is unresponsive to others. Mr. Wallace displays __________.

Module 50
Personality Disorders

personality disorders
characterized by inflexible patterns of thinking, feeling, or relating to others that cause problems in personal, social, and work situations. tend to emerge during late childhood or adolescence and usually continue throughout adulthood

3 categories of personality disorders
-those characterized by odd or eccentric behavior,
-the characterized by dramatic or erratic behavior ones,
-those characterized by anxious or inhibited behavior.

A. Odd/ eccentric-Schizotypal
Weird manners of speaking or dressing. Strange beliefs. “Magical thinking”, such as belief in ESP or telepathy. Difficulty forming relationships. May react oddly in conversation, not respond, or talk to self. Speech elaborate or difficult to follow. (Possibly a mild form of Schizophrenia.)

A. Odd/ eccentric- Paranoid
Distrust in others, suspicion that people have sinister motives. Apt to challenge the loyalties of friends and read hostile intentions into others’ actions. Prone to anger and aggressive outbursts, but otherwise emotionally cold. Often jealous, guarded, secretive, overly serious.

A. Odd/ eccentric- Schizoid
Extreme introversion and withdrawal from relationships. Prefers to be alone, little interest in others. Humorless, distant, often absorbed with own thoughts and feelings, a daydreamer. Fearful of closeness, with poor social skills, often seen as a “loner”.

B. Dramatic/ erratic- Antisocial
Empoverished moral sense or “conscience”. History of deceptions, crime, legal problems, impulsive and aggressive or violent behavior. Little emotional empathy or remorse for hurting others. Manipulative, careless, callous. At high risk for substance abuse and alcoholism.

B. Dramatic/ erratic- Borderline
Unstable moods and intense personal relationships. Frequent mood changes and anger, unpredictable impulses. Self-mutilation or suicidal threats, or gestures to get attention or manipulate others. Self-image fluctuation and tendency to see others as “all good” or “all bad”.

B. Dramatic/ erratic-Histrionic
Constant attention seeking. Grandiose language, provocative dress, exaggerated illness, all to gain attention. Believes that everyone loves him/her. Emotional lively, overly dramatic, enthusiastic and excessively flirtatious.

B. Dramatic/ erratic- Narcissistic
Inflated sense of self-importance, absorbed by fantasies of self and success. Exaggerates own achievement, assumes others will recognize they are inferior. Good first impressions, but poor longer-term relationships. Exploitative of others.

C. Anxious/ inhibited- Avoidant
Socially anxious and uncomfortable, unless he or she is confident of being liked. In contrast with schizoid person, yearns for social contact. Fears critisism and worries about being embarrased in front of others. Avoids social situations, due to fear of rejection.

C. Anxious/ inhibited- Dependent
Submissive, dependent, requiring excessive approval, reassurance and advice. Clings to people and fears losing them. Lacking self-confidence. Uncomfortable when alone. May be devastated by end of close relationship or suicidal, if breakup is threatened.

C. Anxious/ inhibited- Obsessive- compulsive
Conscientious, orderly, perfectionist. Excessive need to do everything “right”. Inflexibly high standards and caution can interfere with his or her productivity. Fears of errors can make this person strict and controlling. Poor expression of emotions. (Not the same as obsessive-compulsive disorder.)

5 axis of the psychological picture of a person
Axis I – clinical.
Axis II – personality.
Axis III – any medical issues that impact upon psychological functioning.
Axis IV – the environmental factors that impact the psychological functioning.
Axis V – the level of overall functioning given the psychological disorder.

borderline personality disorder (BPD)
a psychological disorder characterized by a prolonged disturbance of personality accompanied by mood swings, unstable personal relationships, identity problems, threats of self-destructive behavior, fears of abandonment, and impulsivity.; more frequently found in women than men;

antisocial personality disorder (APD)
characterized by a disregard of the rights of others, and a tendency to violate those rights without being concerned about doing so.; it is the foundation of criminal behavior; mostly found in men; on the other hand, is a type of externalizing disorder in which the problem behaviors (e.g., lying, fighting, vandalism and other criminal activity) focus primarily on harm to others.

As compared to the major clinical disorders described in the DSM-5, the personality disorders are
Both less distressing to the individual and less dysfunctional

Which alternative correctly identifies a personality disorder cluster?
Cluster C – anxious/inhibited

Which of the following correctly defines an important symptom of antisocial personality disorder?
Little emotional empathy or remorse toward others

Carrie is dramatic and emotionally volatile. She rapidly forms intense relationships that seem to blow up or fall apart just as quickly. Although she tends to distrust others, she also needs their attention. Carrie might be diagnosed with _________ personality disorder.

Module 51
Childhood Disorders

attention-deficit hyperactivity disorder (ADHD)
a developmental behavior disorder characterized by problems with focus, difficulty maintaining attention, and inability to concentrate, in which symptoms start before 7 years of age ;can remain problematic in adults, and up to 7% of college students are diagnosed with it

asperger’s disorder
One of the autism spectrum disorders or pervasive developmental disorders, which are a spectrum of psychological conditions that are characterized by abnormalities of social interaction and communication that pervade the individual’s functioning. Differs from others because of its preservation of linguistic and cognitive development

Autism Spectrum Disorder
a neurodevelopmental disorder characterized by persistent deficits in social interaction and communication across different life settings (e.g., home, school) and by restricted and repetitive behavior, interests or activities, and in which symptoms begin during early childhood.

Level 3 Autism Spectrum Disorder
Requiring very substantial support; Substantial deficits in verbal and nonverbal communication cause severe impairments in functioning, very limited initiation of social interaction, and minimal responses to social overtures from others.

Level 2 Autism Spectrum Disorder
Requiring substantial support; Marked deficits in verbal and nonverbal social communication skills; social impairments apparent even with supports in place; limited initiation of social interactions; and reduced or abnormal responses to social overtures from others.

Level 1 Autism Spectrum Disorder
Requiring support; Without support in place, deficits in social communication cause noticeable impairments. Difficulty initiating social interactions, and clear examples of atypical or unsuccessful responses to social overtures from others. May appear to have decreased interest in social interactions. Is able to speak, make sentences, but has difficulty with conversation.

What do ADHD and Autism Spectrum Disorder have in common?
Both disorders are diagnosed more frequently than they were in the past.

Which of the following best defines Autism Spectrum Disorder?
A disorder of neural development characterized by impaired social interaction and repetitive behavior.

Module 52
Controversies and Conclusions

Dissociative Identity Disorder (DID)
a psychological disorder in which two or more distinct and individual personalities exist in the same person, and there is an extreme memory disruption regarding personal information about the other personalities. once known as Multiple Personality Disorder, and this label is still sometimes used. This disorder is sometimes mistakenly referred to as Schizophrenia.

Which of the following statements best summarizes the current state of the field regarding dissociative identity disorder?
Dissociative identity disorder is a controversial disorder, and research can help determine the boundaries of it.