What criteria are used to judge a persons behavior as disordered?

Psychological Disorder: Deviant, Distressful, and Dysfunctional behavior patterns

Deviant-culture, context, and time dependent
Distressful-causing emotion/physical pain and harm
Dysfunctional-behavior has to be disabling enough to disrupt everyday life

U- Unjustifiable (Ex: being mad for no reason, being afraid for no reason)
M- Maladaptive (Ex: adjusting your entire life around a fear)
A- Atypical
D- Disturbing (Ex: physically, mentally disturbing)
Mentally Ill versus Insane
The term insane is not a clinical term, rather a legal term
Insanity defense is rare
It is offensive to refer to a mentally ill individual as crazy or insane
Often we say these terms when we are confused or uncomfortable

The Medical Model

Earlier times evil or strange forces caused psychological abnormalities
Treated with removing the force (teeth pulling, cauterizing, lobotomize, beating, burning,
etc)
Modern times; medical model- the concept that diseases have physical causes that can be
diagnosed and hopefully cured
But not all diseases have physical causes

The Biopsychosocial Approach:

Biological Influences: evolution, individual genes, brain structure and chemistry
Psychological Influences: stress, trauma, learned helplessness, mood related perceptions and
memories
Social-Cultural Influences: roles, expectations, definitions of normality and disorder

Why are psychological disorders classified, and what system is used?

Psychological disorders are classified in order to describe the disorder, predict its future course,
imply appropriate treatment, and stimulate research into its causes.

Disorders are diagnosed based on assessment, interviews, and observations based on the 5 axes
in the DSM-V.

DSM-V -Diagnostic and Statistical Manual of Mental Disorders

Widely used system for classifying psychological disorders
 Axis Category

Axis 1 Clinical psychological syndromes (mood,

anxiety, dissociative, sleep, sexual,
substance-related, schizophrenia, eating, etc)

Axis 2 Personality Disorders

Mental Retardation

Axis 3 General medical conditions (diabetes,

hypertension, arthritis)

Axis 4 Psychosocial or Environmental problems

(social/environmental stressors)

Axis 5 Global Assessment of functioning

Pro DSM-V
Communication between health professionals about care and therapy
It provides a common vocabulary for research and treatment
Anti DSM-V
Labels can stigmatize people
Labels can distort a persons perception of themselves (affecting their well-being) and others
perceptions of them (after treatment)

ADHD (attention-deficit hyperactivity disorder)

A psychological disorder marked by the appearance by age 7 of one or more three key symptoms
Inattention
Hyperactivity
Impulsivity
Does energetic child + boring school = ADHD?
ADHD symptoms are disruptive and can be treated with medication
Anxiety Disorders:
What behaviors categorize anxiety disorders?
Psychological disorders characterized by distressing, persistent anxiety or maladaptive behaviors
that reduce anxiety (dysfunctional anxiety-reducing behaviors).
Generalized Anxiety Disorder:
Often accompanied with depressed mood and even without depression it seems to be disabling
Can lead to physical problems like high blood pressure
By age 50 it becomes rare
Symptoms:
Worry continually
 Jittery
Agitated
Sleep-deprived
Difficult to concentrate
Attention switches from worry to worry
Tension and apprehension may leak out through furrowed brows, twitching eyelids,
trembling, perspiration, or fidgeting
Cannot identify and therefore cannot deal with or avoid its cause
Possible Causes:
Many were maltreated and inhibited as children
Panic Disorder:
An inexplicable repetition of episodes of intense fear that leads to strong physical reactions,
despite a lack of an apparent cause
Episodes are called panic attacks
When panic attacks occur, people can mistake them for heart attacks and even death.
Panic attacks themselves are not life-threatening but can seriously affect one's quality of
life
Symptoms of a panic attack:
Heart palpitations and pounding
Higher heart rate
Sweating and trembling
chills/hot flashes
Symptoms of Panic Disorder:
Sudden and repeated panic attacks
Changes in behavior due to the attacks
Constant and disruptive worry about attacks
Avoiding places attacks may occur
Causes:
Psychological vulnerabilities, stress, unresolved childhood issues, or a combination of all
three are major causes
Genetics
Temperament that is more sensitive to stress or prone to negative emotions
Fight or flight responses-similar reactions that occur in fight-or-flight responses occur in
panic attacks
Shifts in the way parts of your brain function
Obsessive Compulsion Disorder
An anxiety disorder characterized by unwanted repetitive thoughts (obsessions) and /or actions
(compulsions)
Symptoms:
People with OCD have symptoms of obsessions, compulsions, or both.
Obsession Symptoms:
Fear of germs
Unwanted forbidden or taboo thoughts involving sex, religion, and harm
Aggressive thoughts towards others or self
Having things symmetrical or in perfect order
Compulsion Symptoms:
Excessive cleaning and/or handwashing
Repeatedly checking on things
Compulsive counting
Common Behaviors
Cant control his/her thoughts or behaviors, even when recognized as excessive
Spends at least one hour a day on those thoughts or behaviors
Doesnt gain pleasure when performing behaviors, but feel relief from the anxiety of not
doing the behaviors
Significant problems arise from the behaviors they exhibit
Causes:
No definitive cause but many factors correlate within the development of OCD
The brain and genes - can be inherited
Involves problems in communications between the front part of the brain and deeper
structures of the brain (these brain systems use serotonin)
Occurs with other disorders
Faulty beliefs
Phobias/Phobic Disorder:
Phobia- an irrational, intense fear of a person, object, situation, sensation, experience, thought, or
stimulus event that is not shared by the consensual community and is thus out of proportion to
any danger.
Phobic Disorder-a group of disorders in which the significant features (phobias) are persistent
and irrational fears of specific objects, activities, or situations that result in a compelling desire to
avoid the dreaded object, activity, or situation.
Agoraphobia-described as the fear of being in a crowd but also being in open spaces, being
alone, or being trapped
Social Phobia- fear of any type of social situations like social gatherings, meeting new people,
etc
Specific Phobia- a specific phobia is a fear of a specific object, situation, experience, etc.
Symptoms:
Physical: panic attacks in presence of a stimulus
Sweating
Shortness of breath
 Confusion
Pain or tightness in chest
Hot flashes or chills
Choking sensation
Nausea
dizziness
Psychological: thoughts in presence of stimulus
Fear of losing control
Feelings of dread
Fear of fainting
Fear of dying
Causes:
Often because of a stressful or frightening situation
Childhood development from negative experience
Family history of a phobia can lead to one's own development
Symptoms are caused by the release of adrenaline
PTSD: Post-Traumatic Stress Disorder
An anxiety disorder characterized by haunting memories, nightmares, social withdrawal, jumpy
anxiety, and/or insomnia that lingers for four weeks or more after a traumatic experience
Causes:
Traumatizing or life threatening situations
Pre-existing conditions such as depression or anxiety
Symptoms:
Intrusive memories Avoids Negative changes in Emotions
mood

Remembering Thinking Low self esteem anger

traumatic events

Flashbacks Talking Inability to feel Guilt

positive emotions

Nightmares Places Lack of enjoyment in Trouble concentrating

activities

Distress to anything People Hopelessness Insomnia

related to the
traumatic event

Easily startled
Mood Disorders
What behaviors categorize mood disorders, and what causes them?
A mood disorder is a psychological disorder characterized by emotional extremes.
Major Depressive Disorder:
A mood disorder in which a person experiences, in the absence of drugs or a medical condition,
two or more weeks of significantly depressed moods, feelings of worthlessness, and diminished
interest or pleasure in most activities.
Symptoms:
1. Difficulty sleeping or sleeping too much
2. Difficulty concentrating
3. Feeling of hopelessness or helplessness
4. Overwhelming and uncontrollable negative thought
5. Loss of appetite or significant increase in appetite
6. Increase in irritability, aggression or anger
7. Increase in alcohol consumption and/or reckless behavior
8. Thoughts that your life is not worth living
Causes:
1. Abuse
2. Certain medications can cause a high risk of depression
3. Genetics and family history of depression
4. Major events in life, bad or good
5. Death or loss of a loved one
Bipolar Disorder:
previously known as manic depression, causes extreme mood swings with high and low
emotional states that inhibit ones ability to carry out daily tasks
Symptoms:
Manic Episode Depressive Episode

- A Lot of energy. A lot of activity level
- Feeling up or high. Also feels jumpy - Have very little energy. - Have decreased
and weird.
- Trouble sleeping
Talks really fast about different stuff
- Feel like their thoughts are going very fast
- Think they can do a lot of things at once
- Do risky things, like spend a lot of money or
have reckless sex
- Feel very sad, down, empty, or hopeless
activity levels
- Have trouble sleeping, they may sleep too
little or too much
- Feel like they cant enjoy anything. Feel
tired or slowed down
- Feel worried and empty. Have trouble
concentrating
- Forget things a lot
- Eat too much or too little
- Think about death or suicide
Causes:
Family history-tends to run in family lines
Genetics-some research suggests that people with certain genes are more likely to
develop bipolar disorder than others
Biological differences-people with bipolar disorder appear to have physical changes in
their brains
Neurotransmitters-an imbalance in naturally occurring brain chemicals called
neurotransmitters seems to play a significant role in bipolar disorder
Schizophrenia:
What behaviors categorize schizophrenia and what causes the illness?
A neurological disorder characterized by several behaviors including psychotic episodes,
delusions, paranoia, and the inability to correctly perceive reality
Types of Schizophrenia:
Paranoia-
combinations of false beliefs (delusions)and hearing voices (auditory hallucinations
Nearly normal emotions and cognitive functioning but at risk for suicidal behavior
Involves thoughts of persecution or harm by others
Involves exaggerated opinions of self importance
Reflect feelings of jealousy or excessive religiosity

Disorganized-
Disorganized speech, thinking, and behavior
May withdraw socially to an extreme extent
Weak personality structure
Catatonic-
Disturbances of movement such as rigidity, stupor, agitation, bizarre posturing, and
repetitive imitations of other people
At risk for malnutrition, exhaustion, or self injury
Most commonly associated with mood disorders
Residual-
Patients who had at least one acute schizophrenic episode but do not presently have any
strong positive symptoms
May have negative symptoms such as withdrawal from others, meaning the disorder has
not been completely solved
Undifferentiated-
Have both positive and negative symptoms of schizophrenia
Does not meet criterion for the other sub groups
Causes:
There are currently no definite causes. However, researchers believe it may be attributed to
genetics, environmental factors, and brain chemistry.
Symptoms:
-Delusions
-Hallucinations
-Disorganized thinking
-Abnormal Behavior
-Anti-Social Behavior
-Poor thinking skills
-Depressed Mood
-Lack of Motivation
Personality Disorders:
What are the characteristics of personality disorders?
Psychological disorders characterized by inflexible and enduring behavior patterns that impair
social functioning.
Antisocial personality disorder - a personality disorder in which the person (usually a man)
exhibits a lack of conscience for wrongdoing, even toward friends and family members. May be
aggressive and ruthless or a clever con artist
Causes:
-poor abusive relationships
-genes
-changes in brain functions during development
Symptoms:
-deceitfulness
-failure to plan ahead
-irritability
-disregard for safety
-irresponsibility
-lack of remorse
Dissociative Disorders:
What are dissociative disorders and why are they controversial?
Disorders in which conscious awareness becomes separated (dissociated) from previous
memories, thoughts, and feelings
Dissociative Identity Disorder:
A rare dissociative disorder in which a person exhibits two or more distinct and alternating
personalities. Formerly called multiple personality disorder
Symptoms:
1. A sense of being detached from yourself (depersonalization)
 2. Inability to recall specific incidents
3. A perception of the people and things around you as distorted and unreal (derealization)
4. Unable to keep a sense of time
5. Amnesia of certain time periods, events and people
6. Having problems with a split personality
Causes:
1. Innate ability to dissociate easily
2. Repeated episodes of severe physical or sexual abuse in childhood
3. Lack of a supportive or comforting person to counteract abuse
4. Defense procedure to traumatic event
Dissociative Amnesia:
A disorder in which the memory fails with no known organic cause. Can occur spontaneously for
a few hours or days (known as global dissociative amnesia), or after a traumatic event
(situation-specific dissociative amnesia).
Causes:
Overwhelming stress (could be caused by traumatic events)
Genetic link
Symptoms:
The sudden inability to remember past experiences or personal information
May also appear confused
Could suffer from depression and/or anxiety
Dissociative Fugue:
A state of mind wherein ones entire personal identity is abandoned and no other reasonable
explanation (substance abuse, medication, a medical condition) is available.
Causes:
Overwhelming stress-could be because of the result of traumatic events
The use or abuse of alcohol and certain drugs can alo cause this
Symptoms:
Sudden and unplanned travel away from home
Inability to recall past events or important information from the person's life
Confusion or loss of memory about his or her identity, possibly assuming a new identity
to make up for the loss
Extreme distress and problems with daily functioning (due to the fugue episodes)
Why is this controversial: is it a genuine disorder or an extension of our normal capacity for
personality shifts?
Impulse Control Disorders:
Impulse control disorders are a relatively new class of personality disorders characterized by an
ongoing inability to resist impulses to perform actions that are harmful to oneself or others.
Kleptomania: a recurrent urge to steal, typically without regard for need or profit
Symptoms:
Inability to resist powerful urges to steal items that you don't need
Feeling increased tension, anxiety or arousal leading up to the theft
Feeling pleasure, relief or gratification while stealing
Feeling terrible guilt, remorse, self-loathing, shame or fear of arrest after the theft
Return of the urges and a repetition of the kleptomania cycle

Causes:

Changes in the brain

May be linked to problems with a naturally occurring brain chemical (neurotransmitter)
called serotonin
Related to addictive disorders
Brain's opioid system

Pathological Gambling:

Gambling compulsively

Causes: may be from a combination of biological, genetic, and environmental factors

Signs and symptoms:

Being preoccupied with gambling, such as constantly planning how to get more
gambling money
Needing to gamble with increasing amounts of money to get the same thrill
Trying to control, cut back or stop gambling, without success
Feeling restless or irritable when you try to cut down on gambling
Gambling to escape problems or relieve feelings of helplessness, guilt, anxiety or
depression
Trying to get back lost money by gambling more (chasing losses)
Lying to family members or others to hide the extent of your gambling
Jeopardizing or losing important relationships, a job, or school or work
opportunities because of gambling
Resorting to theft or fraud to get gambling money
 Asking others to bail you out of financial trouble because you gambled money away

Pyromania: an obsessive desire to set things on fire

Causes: genetics, neurobiological, and sociological factors
Tends to get worse during periods of personal or family stress
Symptoms:
The repeated and deliberate setting of fires
The fires are not set in an effort to gain financially, express political opinions, to hide a
crime, to express anger, or because of impaired judgement. Nor are they set as a result of
terrorism, delusions, substance abuse, dementia, mental retardation or brain damage
The person setting the fire experiences tension and a sense of arousal beforehand and this
is followed by pleasure and satisfaction once the fire is burning.
The fire setting cannot be accounted for by any other condition such as a manic episode,
a conduct disorder or antisocial personality disorder
Trichotillomania: hair pulling disorder
Symptoms:
Repeatedly pulling your hair out, typically from your scalp, eyebrows or eyelashes, but
sometimes from other body areas, and sites may vary over time
An increasing sense of tension before pulling, or when you try to resist pulling
A sense of pleasure or relief after the hair is pulled
Noticeable hair loss, such as shortened hair or thinned or bald areas on the scalp or other
areas of your body, including sparse or missing eyelashes or eyebrows
Preference for specific types of hair, rituals that accompany hair pulling or patterns of
hair pulling
Biting, chewing or eating pulled-out hair
Playing with pulled-out hair or rubbing it across your lips or face
Repeatedly trying to stop pulling out your hair or trying to do it less often without success
Significant distress or problems at work, school or in social situations related to pulling
out your hair
Causes:
Probably from a combo of genetic and environmental factors
Intermittent Explosive Disorder:
Intermittent explosive disorder (sometimes abbreviated as IED) is a behavioral disorder
characterized by explosive outbursts of anger and violence, often to the point of rage, that are
disproportionate to the situation at hand (e.g., impulsive screaming triggered by relatively
inconsequential events).
Symptoms:
Aggressive episodes may be preceded or accompanied by:
 Rage
Irritability
Increased energy
Racing thoughts
Tingling
Tremors
Palpitations
Chest tightness

The explosive verbal and behavioral outbursts are out of proportion to the situation, with no
thought to consequences, and can include:

Temper tantrums
Tirades
Heated arguments
Shouting
Slapping, shoving or pushing
Physical fights
Property damage
Threatening or assaulting people or animals

You may feel a sense of relief and tiredness after the episode. Later, you may feel remorse, regret
or embarrassment.

Causes: probably due to environmental and biological factors

Environment. Most people with this disorder grew up in families where

explosive behavior and verbal and physical abuse were common. Being
exposed to this type of violence at an early age makes it more likely these
children will exhibit these same traits as they mature.
Genetics. There may be a genetic component, causing the disorder to be
passed down from parents to children.
Brain chemistry. There may be differences in the way serotonin, an
important chemical messenger in the brain, works in people with intermittent
explosive disorder.
Somatoform Disorders:
Somatoform Disorder: Somatic symptom disorder (SSD formerly known as "somatization
disorder" or "somatoform disorder") is a form of mental illness that causes one or more bodily
symptoms, including pain.
Conversion Disorder:
Conversion disorder is a condition in which you show psychological stress in physical ways.
Symptoms:
- Poor balance and coordination
- Paralysis in an extremity like an arm or leg
- Experiencing difficulty swallowing
- Double vision and blindness
- Loss of hearing
- Seizing or convulsing
- Numbness
- Inability to feel pain
- Urinary retention
- Conversion disorder symptoms may appear suddenly after a stressful event or trauma, whether
physical or psychological
Causes:
Stressful event
Emotional conflict
Mental health disorder
Hypochondriasis:
Hypochondriasis is characterized with the idea that one has a serious disease or the fear of
having a serious disease.
Causes:
Major life stress
A severe symptom believed to threaten ones health (e.g., chest pain, memory issues)
History of childhood abuse (physical, sexual, emotional) or neglect
History of childhood illness
Having another mental disorder (e.g., major depression, anxiety, obsessive compulsive
disorders, psychotic disorders)

Symptoms:
Excessive worry over having or getting a serious illness.
Physical symptoms are not present or if present, only mild. If another illness is present, or
there is a high risk for developing an illness, the persons concern is out of proportion.
High level of anxiety and alarm over personal health status.
 Excessive health-related behaviors (e.g., repeatedly checking body for signs of illness) or
shows abnormal avoidance (e.g., avoiding doctors appointments and hospitals).
Fear of illness is present for at least six months (but the specific disease that is feared
may change over that time).
Fear of illness is not due to another mental disorder.
Biomedical Therapy:
Electroconvulsive Therapy (ECT):
Involves an electric shock into the patients head to produce convulsions
Before drugs, it was used to help with many psychological disorders
Side effects include memory loss
Still used primarily for patients with severe depression for people who do not respond to
antidepressant drugs
Psychosurgery:
Includes serious side effects including social withdrawal, seizures, reduced learning and
disability, etc
Method was developed in the 1930s and was used more before the 1950s
Best known example of this technique is a frontal lobotomy
Before drugs, it was used to help with many psychological disorders
This technique is rarely used today
Antianxiety Drugs:
The drug works by depressing the activity in the nervous system (lowering heart rate and
breathing).
The drug has also been used to help people with anxiety disorders like
obsessive-compulsive disorder
Type of drug that helps people with panic attacks and serious distress or tension
A person taking this drug can develop a dependence (addiction) on the drug
Antidepressant Drugs:
The drug has also been used to help people with anxiety disorders like
obsessive-compulsive disorder
The drug works by increasing the amount of norepinephrine and serotonin in the body
that increase activity levels
Selective-serotonin reuptake inhibitors (SSRIs) are used to partially block the
reabsorption and removal of serotonin from synapses
Type of drug that helps people with major depression and eating disorders
Treatment can take up to a month due to neurogenesis
Lithium:
This drug effect several neurotransmitters that work to stabilize cycles of mania (highs)
and depression (lows)
Type of drug that helps many people with bipolar disorder
Antipsychotic Drugs:
Atypical antipsychotics are used to target both dopamine and serotonin receptors
Side effects could include sluggishness, tremors, and twitches and possible tardive
dyskinesia
 Type of drug that helps people with schizophrenia; helps people with hallucinations and
paranoia
The drug helps to block the activity of dopamine in the brain and reduces agitation,
hallucinations, and delusions