Psychological Disorders: Concepts, Classification, and Anxiety-Related Disorders

Psychological Disorders

Basic Concepts of Psychological Disorders

Psychological disorders are patterns of thoughts, feelings, or behaviors that are deviant, distressful, and dysfunctional. Understanding these concepts is essential for identifying and classifying mental health conditions.

• Dysfunction: Refers to impairment in the ability to perform normal daily activities due to psychological symptoms. Dysfunction can affect work, relationships, and self-care.

• Distress: Indicates the subjective experience of suffering or discomfort caused by psychological symptoms. Distress is a key criterion for diagnosing many disorders.

• Example: An individual with major depressive disorder may experience dysfunction in maintaining employment and distress due to persistent sadness.

Understanding Psychological Disorders

Multiple factors contribute to the development of psychological disorders. The biopsychosocial approach integrates biological, psychological, and social-cultural influences.

• Biological factors: Genetics, brain structure, and neurochemistry.

• Psychological factors: Stress, trauma, learned behaviors, and cognitive patterns.

• Social-cultural factors: Family, culture, and societal expectations.

• Example: Depression may result from a combination of genetic predisposition, negative thinking patterns, and stressful life events.

Classifying Disorders – and Labeling People

Classification systems help clinicians diagnose and treat psychological disorders. The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) is the primary tool used in the United States for this purpose.

• DSM-5: Provides standardized criteria for diagnosing mental disorders, including symptom lists and duration requirements.

• Labeling: While classification aids treatment, labels can lead to stigma and discrimination.

• Example: A diagnosis of schizophrenia requires meeting specific DSM-5 criteria for symptoms and duration.

Thinking Critically About: ADHD – Normal High Energy or Disordered Behavior?

Attention-Deficit/Hyperactivity Disorder (ADHD) is characterized by patterns of inattention, hyperactivity, and impulsivity. Distinguishing between normal high energy and disordered behavior requires careful assessment of dysfunction and distress.

• Key Point: Not all high-energy behavior in children is pathological; diagnosis depends on the degree of impairment and distress.

• Example: A child who cannot focus in multiple settings and whose behavior disrupts learning may meet criteria for ADHD.

Risk of Harm to Self and Others

Some psychological disorders increase the risk of self-harm or harm to others. Understanding these risks is crucial for prevention and intervention.

• Understanding Suicide: Suicide is a major public health concern, often associated with mood disorders. Warning signs include talking about death, withdrawal, and hopelessness.

• Nonsuicidal Self-Injury (NSSI): Deliberate self-harm without intent to die, such as cutting or burning. NSSI is often a coping mechanism for emotional pain.

• Does Disorder Equal Danger? Most individuals with psychological disorders are not violent. The risk of harm to others is generally low, except in specific conditions (e.g., some psychotic disorders).

• Example: A person with severe depression may be at risk for suicide but not for harming others.

Anxiety-Related Disorders

Anxiety Disorders

Anxiety disorders involve excessive fear or anxiety that interferes with daily functioning. They are among the most common mental health conditions.

• Generalized Anxiety Disorder (GAD): Persistent, excessive worry about various aspects of life, often accompanied by physical symptoms such as restlessness and muscle tension.

• Panic Disorder: Recurrent, unexpected panic attacks—sudden episodes of intense fear with physical symptoms like heart palpitations, shortness of breath, and dizziness.

• Specific Phobias: Intense, irrational fear of specific objects or situations (e.g., heights, spiders) that leads to avoidance behavior.

• Example: Someone with a specific phobia of flying may avoid air travel despite needing to travel for work.

Obsessive-Compulsive and Related Disorders

These disorders are characterized by unwanted repetitive thoughts (obsessions) and/or actions (compulsions).

• Obsessive-Compulsive Disorder (OCD): Involves obsessions (intrusive, unwanted thoughts) and compulsions (repetitive behaviors performed to reduce anxiety).

• Difference between obsessions and compulsions:

  • Obsessions: Persistent, intrusive thoughts, images, or urges (e.g., fear of contamination).

  • Compulsions: Repetitive behaviors or mental acts performed to relieve anxiety caused by obsessions (e.g., excessive handwashing).

• Example: A person with OCD may repeatedly check if doors are locked to prevent harm.

Posttraumatic Stress Disorder (PTSD)

PTSD develops after exposure to a traumatic event. Symptoms include intrusive memories, avoidance, negative changes in mood, and heightened arousal.

• Key Point: Not everyone exposed to trauma develops PTSD; risk factors include severity of trauma and lack of social support.

• Example: A combat veteran experiencing flashbacks and nightmares months after returning home may have PTSD.

Somatic Symptom and Related Disorders

These disorders involve physical symptoms that cannot be fully explained by a medical condition, often accompanied by excessive thoughts, feelings, or behaviors related to the symptoms.

• Somatic Symptom Disorder: One or more physical symptoms (e.g., pain, fatigue) that cause significant distress or dysfunction, with excessive thoughts or behaviors about the symptoms.

• Illness Anxiety Disorder: Preoccupation with having or acquiring a serious illness, despite minimal or no physical symptoms and repeated medical reassurance.

• Example: An individual who frequently visits doctors for various aches, convinced they have a serious disease despite negative test results, may have illness anxiety disorder.