Psychological Disorders

 

Objectives:

1. List the criteria for judging whether behavior is disordered.

2. Explain and contrast two perspectives on psychological disorders.

3. Describe the system used to classify psychological disorders and explain the reasons for its development.

4. Discuss the controversy surrounding the use of diagnostic labels.

5. Describe the various anxiety disorders.

6. Discuss anxiety disorders from the psychoanalytic, learning, and biological perspectives.

7. Describe two principal mood disorders.

8. Discuss the alternative explanations for mood disorders.

9. Describe the nature and possible causes of dissociative disorders.

10. Describe the symptoms and types schizophrenia.

11. Discuss research on the causes of schizophrenia.

12. Describe the nature and causes of personality disorders and the specific characteristics of the antisocial personality disorder.

13. Briefly discuss the prevalence of psychological disorders.

 

Vocabulary:

1. psychological disorder—

2. medical model—

3. bio-psycho-social perspective—

4. DSM‑IV—

5. neurotic disorders—

6. psychotic disorders—

7. anxiety disorders—

8. generalized anxiety disorder—

9. panic attack—

10. phobia—

11. obsessive-compulsive disorder—

12. mood disorders—

13. major depressive disorder—

14. mania episode—

15. bipolar disorder—

16. dissociative disorders—

17. dissociative identity disorder—

18. schizophrenia—

19. delusions—

20. personality disorders—

21. antisocial personality disorder—

 

 

 

 

Short answers:

1. Psychological disorders are harmful dysfunction that must be judged to be atypical, disturbing, maladaptive, and unjustifiable. This definition emphasizes that standards of acceptability for behavior are variable (constant / variable).

2. The view that psychological disorders are sicknesses is the basis of the medical model. According to this view, psychological disorders are viewed as mental illness, or psychopathology.

3. One of the first reformers to advocate this position and call for providing more humane living conditions for the mentally ill was Pinel.

4. Today’s psychologists recognize that all behavior arises from the interaction of nature and nurture. To presume that a person is “mentally ill” attributes the condition solely to an internal problem.

5. Major psychological disorders such as depression and schizphrenia are universal; others, such as anorexia nervosa and bulimia are culture‑bound. These culture-bound disorders may share an underlying dynamic, such as anxiety, yet differ in their symptoms.

6. Most mental health workers today work from the bio -psycho-social perspective, which assumes that disorders are influenced by genetic predispositions, inner psychological dynamics, and social and cultural circumstances.

7. The most widely used system for classifying psychological disorders is the American Psychiatric Association manual, commonly known by its abbreviation, DSM-IV. This manual defines 400 categories of “mental disorder,” divided into 17 major categories.

8. Psychological illnesses that are severely impairing, called psychotic disorders, are contrasted with neurotic disorders, or psychological illnesses that allow the person to function socially. In general, DSM-IV now seeks to list and describe disorders, rather than attempting to explain their causes.

9. Independent diagnoses made with the current manual generally show (show / do not show) agreement.

10. One criticism of DSM-IV is that as the number of disorder categories has increased (increased / decreased), the number of adults who meet the criteria for a least one psychiatric ailment has increased (increased / decreased).

11. (Close-up) Briefly describe the “unDSM.”

The “unDSM” is a new classification system that identifies 24 human strengths and virtues grouped into six clusters: wisdon and knowledge, courage, love, justice, temperance, and transcendance.

12. Studies have shown that labeling has a significant (little  /a significant) effect on our interpretation of individuals and their behavior.

13. Outline the pros and cons of labeling psychological disorders.

Psychological labels can be arbitary. They can create preconceptions that bias our perceptions and interpretations and they can affect people’s self-images. Moreover, labels can change reality, by serving as self-fulfilling prophecies. Despite these drawbacks, labels are useful in describing, treating, and researching the causes of psychological disorders.

 

14. When a person tends to feel anxious for no appar­ent reason, he or she is diagnosed as suffering from a generalized anxiety disorder.

15. In generalized anxiety disorder, the body reacts physiologically with the arousal of the autonomic nervous system. In some instances the anxiety of this disorder may intensi­fy dramatically and be accompanied by trembling or dizziness; this is called a panic disorder.

16. People who fear situations in which escape or help might not be possible when panic strikes suffer from agoraphobia.

17. When a person has an irrational fear of a specific object, activity, or situation, the diagnosis is a phobia disorder. Although in many situations, the person can live with the problem, some specific phobias, such as a fear of thunderstorms, are incapacitating.

18. When a person has an intense fear of being scrutinized by others, the diagnosis is a social phobia.

19. When a person cannot control repetitive thoughts and actions, an obsessive - compulsive disorder is diagnosed. Older people are less (more / less) likely than teens and young adults to suffer from this disorder.

20. Freud assumed that anxiety disor­ders are symptoms of submerged mental energy that derives from intolerable impulses that were repressed during childhood.

21. Learning theorists, drawing on research in which rats are given unpredictable shocks, link general anxiety with classical conditioning of fears.

22. Some fears arise from stimulus generalization, such as when a person who fears heights after a fall also comes to fear airplanes.

23. Phobias and compulsive behaviors reduce anxiety and thereby are reinforced. Through observational learning, someone might also learn fear by seeing others display their own fears.

24. Humans probably are (are / are not) biologically prepared to develop certain fears. Compulsive acts typically are exaggerations of behaviors that contributed to our species’ survivial.

25. The anxiety response probably is (is / is not) genetically influenced.

26. PET scans of persons with obsessive‑compulsive disorder reveal excessive activity in a region of the frontal lobes. Some antidepressant drugs dampen fear-circuit activity in the amygdala, thus reducing this behavior.

27. (Close-Up) Traumatic stress, such as that associated with witnessing atrocities or combat, can produce post-traumatic stress disorder, symptoms of which include haunting memories, nightmares, social withdrawal, and anxiety or depression. Despite such symptoms, some psychologists believe this disorder is a fad diagnosis.

28. The leading cause of disability worldwide is mood disorders. The experience of prolonged depression with no discernible cause is called major depression disorder.

29. When a person’s mood alternates between depression and the hyperactive state of mania, a bipolar disorder is diagnosed.

30. Although phobias disorders are more common, depression is the number one reason that people seek mental health services.

31. In between the temporary blue moods everyone experiences and major depression is a condition called dysthymic disorder, in which a person feels down-in-the-dumps nearly every day for two years or more.

32. The possible signs of depression include lethargy, feelings of worthlessness, and loss of interest in family, friends, and activities.

33. Major depression occurs when its signs persist two weeks or more with no apparent cause.

34. Depressed persons usually can (can / cannot) recover without therapy.

35. Symptoms of mania include euphoria, hyperactivity, and a wildly optimistic state. The bipolar disorder occurs in approximately 1 percent of men and women.

36. Compared with men, women are more (more / less) vulnerable to major depression. In general, women are most vulnerable to passive (active / passive) disor­ders, such as depression, anxiety, and inhibited sexual desire. Men’s disorders tend to be active (active / passive), and include alcohol abuse, antisocial conduct, and lack of impulse control.

37. It usually is (is / is not) the case that a depressive episode has been triggered

by a stressful event.

38. With each new generation, the rate of depression is increasing (increasing / decreasing) and the disorder is striking earlier (earlier / later). In North America today, young adults are 3 times (how much?) as likely as their grandparents to suffer depression.

39. State the psychoanalytic explanation of depression.

Adulthood depression can be triggered by losses that evoke feelings associated with earlier childhood losses. Alternatively, unresolved anger is turned inward and takes the form of depression.

 

40. Mood disorders tend (tend / do not tend) to run in families. Studies of twins also reveal that genetic influences on mood disorders are strong (weak / strong).

41. To determine which genes are involved in depression, researchers use linkage analysis, in which they examine the DNA of both affected and unaffected family members.

42. Depression may also be caused by low (high / low) levels of two neurotransmitters, norepinephrine or serotonin.

43. Drugs that alleviate mania reduce norephinephrine; drugs that relieve depression increase norephinephrine or serotonin by blocking their reuptake or their chemical breakdown.

44. The brains of depressed people tend to be less (more / less) active, especially in an area of the left frontal lobe of the brain. In severely depressed patients, this brain area may also be smaller (smaller / larger) in size. The brain’s hippocampus, which is important in processing memories, is vulnerable to stress-related damage. Antidepressant drugs that boost serotonin may promote recovery by stimulating neurons in this area of the brain.

45. (Close-Up) Identify several group differences in suicide rates.

Suicide rates are higher amoung white Americans, the rich, older men, the nonreligious, and those who are single, widowed, or divorced. Although women more often attempt suicide, men are more likely to succeed. Suicide rates also vary widely around the world.

 

46. According to the social‑cognitive perspective, depression may be linked with beliefs that are self - defeating. Such beliefs arise from learned helplessness, the feeling that can arise when the individual repeatedly experiences uncontrollable aversive events.

47. Gender differences in uncontrollable stress help explain why women have been twice as vulnerable to depression.

48. Describe how depressed people differ from others in their explanations of failure and how such explana­tions tend to feed depression.

Depressed people are more likely than others to explain failures or bad events in terms that are stable (it’s going to last forever), global (it will affect everything), and internal (it’s my fault). Such explanations lead to feelings of hopelessness, which in turn feed depression.

 

49. Research studies suggest that depressing thoughts usually coincide with (precede / follow / coincide with) a depressed mood.

50. Depression-prone people respond to bad events in an especially self-focused, self-blaming way.

51. Recent research studies with college students reveal that negative thinkers are vulnerable to depression. Students who exhibit optimism develop more social support.

52. Being withdrawn, self-focused, and complaining tends to elicit social rejection (empathy / rejection).

53. Outline the vicious cycle of depression.

Depression is often brought on by stressful experiences. Depressed people brood over such experiences with maladaptive explanations that produce self-blame and amplify their depression, which in turn triggers other symptoms of depression. In addition, being withdrawn and complaining tends to elecit social rejection and other negative experiences.

54. In dissociative disorders a person’s conscious awareness becomes separated from painful memories, thoughts, and feelings.

55. A person who develops two or more distinct per­sonalities is suffering from a dissociative identity disorder.

56. Nicolas Spanos has argued that such people may merely be playing different roles.

57. Those who accept this as a genuine disorder point to evi­dence that differing personalities may be associat­ed with distinct brain and body states.

58. Identify two pieces of evidence brought forth by those who do not accept dissociative identity disorder as a genuine disorder.

Skeptics point out that the recent increase in the number of reported cases of dissociative identity disorder indicates that it has become a fad. The fact that the disorder is almost nonexistent outside North America also causes skeptics to doubt the disorder’s genuineness.

 

59. The psychoanalytic and learning perspectives view dissociative disorders as ways of dealing with anxiety. Others view them as a protective response to histories of childhood trauma. Skeptics claim these disorders are sometimes contrived by fantasy-prone people, and sometimes constructed out of the therpist-patient interaction.

60. Schizophrenia, or “split mind,” refers not to a split personality but rather to a split from reality.

61. Three manifestations of schizophrenia are disor­ganized thinking, disturbed perceptions, and inappropriate emotions and actions.

62. The distorted, false beliefs of schizophrenia patients are called delusions.

63. Many psychologists attribute the disorganized thinking of schizophrenia to a breakdown in the capacity for selective attention.

64. The disturbed perceptions of people suffering from schizophrenia may take the form of hallucinations, which usually are auditory (visual / auditory).

65. Some victims of schizophrenia lapse into a zombie like state of apparent apathy, or flat affect; others, who exhibit catatonia, may remain motionless for hours.

66. The term schizophrenia describes a cluster of disorders (single disorder / cluster of disorders).

67. Positive symptoms of schizophrenia include disorganized and deluded thinking, inappropriate emotions. Negative symptoms include expressionless faces, toneless voices, mute or rigid bodies.

68. When schizophrenia develops slowly (called chronic or process schizophrenia), recovery is less (more  /less) likely than when it develops rapidly in reaction to par­ticular life stresses (called  acute or reactive schizophrenia).

69. The brain tissue of schizophrenia patients has been found to have an excess of receptors for the neurotransmitter dopamine. Drugs that block these receptors have been found to decrease (increase/decrease) schizophrenia symptoms. Drugs that interfere with receptors for the neurotransmitter glutamate can produce negative symptoms of schizophrenia.

70. Brain scans have shown that many people suffer­ing from schizophrenia have abnor­mal patterns of brain activity in the frontal lobes.

71. Enlarged fluid-filled areas and a corresponding shrinkage of cerebral tissue is also characteristic of schizophrenia. Schizophrenia patients also have smaller-than-normal thalamus, which may account for their difficulty in filtering sensory input and focusing attention.

72. Some scientists content that the brain abnormali­ties of schizophrenia may be caused by a prenatal problem, such as low birth weight, birth complications such as oxygen deprivation, or a

viral infection contracted by the mother.

73. List several pieces of evidence for this theory.

Risk of schizophrenia increases for those who undergo fetal development during a flu epidemic, or simply during flu season. People born in densely populated areas and those born during winter and spring months are at increased risk. The months of excess shizophrenia births are reversed in the southern hemisphere, where the seasons are the reverse of the northern hemisphere’s. As infectious disease rates have declined, the incidence of schizophrenia has also declined.

 

74. Twin and adoptive studies support (support / do not sup­port) the contention that heredity plays a role in schizophrenia.

75. The role of the prenatal environment in schizophrenia is demonstrated by the fact that identical twins who share the same placenta, and are therefore more likely to experience the same prenatal viruses, are more likely to share the disorder.

76. Although adoption studies do (do / do not) confirm the genetic link, other factors such as prenatal viral infections and deprivation of nutrition or oxygen at birth may also be factors in the disease.

77. It appears that for schizophrenia to develop there must be both a genetic predispo­sition and some psychological trigger.

78. List several of the warning signs of schizophrenia in high‑risk children.

Severe, long lasting schizophrenia in the mother; complications at birth and low birth weight; separation from parents; short attention span and poor muscle coordination; disruptive or withdrawn behavior; emotional unpredictability; and poor peer relations.

 

79. Personality disorders exist when an individual has character traits that are enduring and impair social functioning.

80. An individual who seems to have no conscience, lies, steals, is generally irresponsible, and may be criminal is said to have an antisocial personality. Previously, this person was labeled a psychopath or sociopath.

81. Studies of the children of convicted criminals suggest that there is (is / is not) a biological predisposition to such traits.

82. When awaiting electric shocks, antisocial persons show little (little / some / much) arousal of the autonomic nervous system than do control subjects.

83. Some studies have detected early signs of antisocial behavior in children as young as 3 to 6. Antisocial adolescents tended to have been impulsive, uninhibited, unconcerned with social rewards, and low in anxiety.

84. PET scans of murderers’ brains reveal reduced activity in the frontal lobe.

85. As in other disorders, in antisocial personality, genetics is not (is / is not) the whole story.

86. Research reveals that approximately one in every 6 (how many?) Americans suffers clinically significant mental disorders.

87. The incidence of serious psychological disorders is higher (higher / lower) among those below the poverty line.

88. In terms of age of onset, most psychological dis­orders appear by early (early / middle / late) adulthood. Some, such as the antisocial personality and phobias, appear during childhood.