Psychological Disorders: Definitions, Perspectives, and Major Classes

Psychological Disorders

Introduction

Psychological disorders, also known as mental disorders, are patterns of behavioral or psychological symptoms that impact multiple areas of life. These disorders create distress for the person experiencing these symptoms. Understanding psychological disorders involves examining definitions, historical perspectives, diagnostic criteria, and major classes of disorders.

Defining Abnormal Behavior

What is Abnormal?

Abnormal behavior is a social construct and is typically defined using the "3 D's":

• Distressing: Causes distress to the individual or others.

• Dysfunctional: Interferes with the person's ability to function in daily life or is dysfunctional for society.

• Deviant: Violates social norms or expectations.

Judgments of abnormality often require that behavior is distressing, dysfunctional, or deviant.

Historical Perspectives on Abnormal Behavior

Historical Conceptions

• Major psychological disorders have existed in all cultures and across all time periods.

• Examples from history include references in Homer's Odyssey, Hippocrates's four humors (blood, phlegm, yellow bile, black bile), and Freud's psychosexual stages.

Three Dominant Traditions

• Supernatural: Disorders attributed to supernatural forces (e.g., possession by spirits).

• Biological: Disorders seen as diseases affecting the brain (e.g., Hippocrates, 5th Century B.C.).

• Psychological: Disorders explained by psychological processes.

Demonological View

• Abnormal behavior was believed to result from supernatural forces or spirit possession.

• Treatment: Trephination (drilling a hole in the skull) was used to release evil spirits.

Early Biological Views

• Mental illnesses were considered diseases like physical illnesses that affect the brain.

• Breakthrough: Discovery that general paresis was caused by syphilis, linking some disorders to physical causes.

• Current understanding includes both physiological and psychological factors.

Major Psychological Perspectives

• Psychoanalytic: Inappropriate use of defense mechanisms leads to neuroses; withdrawal from reality leads to psychoses.

• Behavioral: Disorders are learned responses to environmental stimuli.

• Cognitive: Disorders arise from maladaptive thought processes.

• Humanistic: Disorders result from frustrations in achieving self-actualization and negative self-concept.

Vulnerability-Stress Model

Overview

The vulnerability-stress model explains the development of psychological disorders as the result of the interaction between individual vulnerabilities and stressful life events.

• Incorporates: Biological, environmental, and psychological levels.

• Vulnerability: Predisposition to disorders due to biological basis, personality, or environmental factors.

• Predisposition: Disorder develops only when a person with vulnerability is exposed to a stressor.

• Stressor: An event that requires the person to cope.

Anxiety Disorders

Definition and Features

Anxiety disorders are characterized by excessive and persistent feelings of apprehension and fear that are not proportional to actual threats. These disorders interfere with daily functioning.

• Examples: Phobias, Generalized Anxiety Disorder, Obsessive-Compulsive Disorder (OCD).

Biological Factors

• Genetics: Monozygotic (MZ) twins are more similar in anxiety levels than dizygotic (DZ) twins.

• GABA: Low levels of the neurotransmitter GABA may cause highly reactive nervous systems.

Gender Differences

• Females exhibit more anxiety disorders than males, with differences emerging as early as age seven.

• Possible explanations include sex-linked biological disposition and less power/personal control for women.

Psychological Factors

• Psychodynamic: Neurotic anxiety arises when unacceptable impulses threaten to overwhelm the ego's defenses.

• Cognitive: Maladaptive thoughts and beliefs, with a tendency to appraise situations catastrophically.

Learning Explanations

• Classical Conditioning: Associating an object or situation with pain or trauma.

• Modeling: Learning by observing others' anxious responses.

Sociocultural Factors

• Cultural norms define what is considered important or threatening.

• Some anxiety disorders are "culturally bound" (e.g., fear of offending someone, fear of being fat).

Mood (Affective) Disorders

Depression

• Not simply "the blues" or a bad day; clinical depression involves symptoms that are frequent, intense, and out of proportion to the situation.

• Major Depression: Inability to function effectively in daily life.

• Dysthymia: Chronic disruption of mood, less severe but longer-lasting than major depression.

Symptoms of Depression

Domain	Symptoms
Emotional	Negative mood state
Cognitive	Difficulty concentrating, feelings of inferiority and failure, pessimism
Motivational	Loss of interest and drive
Somatic	Appetite loss, compulsive eating, sleep disturbances

Prevalence and Gender Differences

• 1 in 20 North Americans is severely depressed.

• 1 in 5 will have a depressive episode of clinical proportions during their lifetime.

• Women are twice as likely to suffer from unipolar depression; no gender difference for bipolar disorder.

Biological Explanations

• Depression: Genetic factors, biochemical differences, and underactivity of norepinephrine, dopamine, and serotonin.

• Bipolar Disorder: Stronger genetic component than unipolar depression; 50% have a relative with the disorder.

Cognitive Processes

• Depressive Cognitive Triad: Negative thoughts about the world, oneself, and the future.

• Inability to suppress negative thoughts; tendency to recall more failures than successes.

• Depressive Attributional Pattern: Success attributed to external factors; negative outcomes attributed to personal factors.

• Learned Helplessness: Expectation that bad events will occur and inability to cope with them.

Learning and Environmental Factors

• Learning: Loss of reinforcement leads to depression, which can cause loss of social support.

• Environmental: Poor parenting, many stressful experiences, failure to develop coping skills or a positive self-concept.

Sociocultural Factors

• Prevalence of depressive disorders is lower in Hong Kong and Taiwan than in Western countries.

• Feelings of guilt and inadequacy are highest in North America and Western Europe.

Schizophrenia

Definition and Features

Schizophrenia ("split-mind") is a severe psychological disorder characterized by profound disturbances in thinking, perception, emotion, and behavior.

• Delusions: False beliefs not based in reality.

• Disorganized Speech: Use of strange words or incoherent speech.

• Hallucinations: False perceptions, often auditory or visual.

• Blunted or inappropriate affect: Emotional responses that are absent or inappropriate.

Categories of Schizophrenia

Type I	Type II
Predominance of positive symptoms		Predominance of negative symptoms
Pathological extremes	Absence of normal reactions
Delusions, hallucinations, disordered speech & thought	Lack of emotion, expression, motivation

Prevalence and Prognosis

• Affects about 1% of the population, with equal numbers of males and females.

• 10% are permanently impaired, 65% have intermittent periods of functioning, and 25% recover.

• Negative symptoms are associated with a long history of poor functioning and poor recovery; positive symptoms are associated with better prognosis.

Biological Factors

• Genetics: Higher concordance rates among twins.

• Brain: Neurodegenerative hypothesis suggests atrophy and destruction of neural tissue.

• Thalamus: Abnormal MRI activity; routes sensory information.

Biochemical Factors

• Dopamine Hypothesis: Overactivity of the dopamine system is linked to schizophrenia.

• Dopamine regulates emotion, motivation, and cognitive functioning.

• Antipsychotic drugs reduce dopamine activity to manage symptoms.

Additional info: For more detailed study, students should refer to the DSM-5 for diagnostic criteria and consult primary research articles for current biological and psychological theories.