Psychological Disorders

Defining Abnormality
• It is hard to define abnormal behavior, however there
can be different definitions for abnormality:
1. “Abnormality is the deviation from the average”, so
according to this definition persons with high IQ scores are
also abnormal.
2. “Abnormality is the deviation from the ideal”, according to
this definition ideal standards vary from one society to
another, so this definition is also un-appropriate.
3. “Abnormality as a sense of personal discomfort”, but even
people with anxiety and distress can be happy and therefore
hard to call them abnormal.
4. “Abnormality is the inability to function effectively”, so
according to this definition these people are unable to adjust
to the demands of society.
5. “Abnormality is a legal concept”, but law differs from
society to society.
• (Psychologists Definition of Abnormality)
– “Behavior that causes people to experience distress and prevent
them from functioning in their daily lives”.

• Case Study: Ariel Merai studied Palestinian & Lebanese

suicide bombers and profiled them where some were
married some un-married, some rich and others poor,
some educated and some un-educated.
• Most suicide bombers were sociable, they were
psychologically normal.
• Suicide bombers according to psychologists are driven
by complex web of emotions, loyalties and politics rather
personal distress.
 Major Psychological Disorders
• Anxiety Disorders:
– Feeling of tension or apprehension without an obvious external
cause, affecting daily functioning.
• Four Types of Anxiety Disorders:
1. Phobic Disorders: Intense, irrational fears of specific objects or
situation. Phobia is because of external stimulus.
– E.g., Acrophobia (fear of heights)
– Aerophobia (flying)
– Aquaphobia (water)
– Hydrophobia (water)
– Xenophobia (strangers)
– Pyrophobia (fire)
– Nyctophobia (darkness)
– Ophidiophobia (snakes)
2. Panic Disorder:
– Anxiety disorder that takes the form of panic attacks lasting from a few
seconds to as long as several hours.
– Panic disorders do not have any identifiable stimuli and often during the
panic anxiety comes suddenly and often without warning rises to peak
and individual feels like doom.
– Symptoms of Panic disorder may include: heart beat, shortness of
breath, unusual amounts of sweating, faintness, urge to urinate, gastric
sensations.
– After the panic attack people tend to feel exhausted.
– Some people with panic disorder develop a complication called
“Agoraphobia”. In extreme cases people with agoraphobia never leave
their homes.
3. Generalized Anxiety Disorder:
– The experience of long-term, persistent anxiety and worry.
– In some cases people disorder feel that something dreadful is going to
happen and can’t identify the reason.
– People with generalized anxiety disorder may develop headaches,
dizziness, heart palpitations, or insomnia.
4. Obsessive-compulsive Disorder:
– “A disorder characterized by obsessions or compulsions.”

– Obsession:
• “A persistent, unwanted thought or idea that keeps recurring.”
• E.g., thought repeating in your mind that you have forgot to lock the door etc.
• Some one may complain that some unwanted tune is running through his
head over and over .
• In serious obsessions thoughts may persist for days or months and may
result in troubling images.

– Compulsions:
• “An irresistible urge to repeatedly carry out some act that seems
strange and unreasonable.”
• In compulsions people experience extreme anxiety if they cannot carry out
they actions. E.g., Checking the stove whether its turned off or not.
• Causes of Anxiety Disorders
– Genetic Factors:
• If in twins, one is having panic disorder, there is 30% possibility that
other will have panic disorder.
• Some chemical deficiencies in brain may cause some type of
anxiety.
– Behavioral Factors:
• If dog bites to once, next time you see dog will produce anxiety in
you.
– Cognitive Factors:
• People maladaptive thoughts and beliefs about the world are the
roots of an anxiety.
• Somatoform Disorders:
– “Psychological difficulties that take on physical (somatic) form, but for which
there is no medical cause.”

– Hypochondriasis:
• “A disorder in which people have a constant fear of illness and preoccupation
with their illness.”
• People with hypochondriasis believe everyday aches and pains are symptoms of a
dread disease.
– Conversion Disorder:
• “A major somatoform disorder that involves an actual physical disturbance, such
as the inability to use sensory organ or the complete or partial inability to move
an arm or leg.”
• E.g., You may wake up one morning blind, deaf or numb without any medical reason,
the problem may disappear later.

• The exact cause of conversion disorder is unknown, how ever stressful event, an
emotional conflict or another mental health disorder, such as depression can be cause.

• Some researchers think the part of the brain that controls your muscles and senses
may be involved. It may be the brain's way of coping with something that seems like a
threat.
• Dissociative Disorders:
– “Disorder in which critical parts of the personality are separated in
order to avoid or escape stress.”
1. Dissociative Identity Disorder or Multiple Personality
Disorder: “A disorder in which a person displays characteristics
of two or more distinct personalities.”
• In dissociative identity disorder, you may feel the presence of
one or more other people talking or living inside your head..
2. Dissociative Amnesia:
• “A disorder in which a significant, selective memory loss occurs.”
• In dissociative amnesia, the forgotten material is still present in the
memory but is difficult to be recalled. In profound cases of dissociative
amnesia, person may totally forget the address, relatives etc.
3. Dissociative Fugue:
• “A form of amnesia in which a person leaves home and sometimes
assumes a new identity.”
• Mood Disorders:
– “Strong emotional disturbances that interrupt everyday life.”
– E.g., Sometimes we are happy, at other times we are sad and upset; its
normal part of every day life. But when our mood interferes with our
everyday life, it becomes mood disorder.
– Major Depression:
• “A severe form of depression that interferes with concentration, decision
making, and sociability.”
• E.g., Loss of job, death of beloved ones, breakup of long-term relationships
etc, are normal part of life, but when you begin to feel useless, worthless,
lonely and may feel hopeless for months and years; and you may cry un-
controllably, have sleep disturbances and risk for suicide, so you have major
depression.
• In USA, at any one time 6 to 10% of the US population is clinically
depressed.
• Females are twice as likely to experience major depression as men.
• According to 2003-2004 statistics, in USA some 15 million people suffer from
major depression and the cost of depression approaches $50 billion a year.
• Mania and Bipolar Disorder:
– “An extended state of intense wild delight (joy).”
– People with mania feel intense happiness, power and energy.
– They may believe that they will succeed at anything they
attempt.
• Bipolar Disorder:
– “A disorder in which a person interchanges between mania and
periods of depression.”
– This interchange between mania and depression may be of days
to years.
– Normally periods of depression are usually longer than periods
of mania.
– People who experience mania, may sometimes cause emotional
and physical self-injury.
 Test for Depression
• I feel downhearted, depressed, and sad.
• I don’t enjoy the things that I used to.
• I feel that others would be better off if I were dead.
• I feel that I am not useful or needed.
• I notice that I am loosing weight.
• I have trouble sleeping through the night.
• I am restless and can’t keep and can’t keep still.
• My mind isn’t as clear as it used to be.
• I get tires for no reason.
• I feel hopeless about the future.

• If you click yes to at least five of the statements, including either

item 1 or 2 and if you have had these problems for at least 1 or 2
weeks. If you click yes to number 3, you should seek help of
psychologist immediately.
US. National Depression Screening
Day. 2003
 Causes of Mood Disorders
• Different approaches explain causes of mood disorder in different ways.
– Psychoanalytic Approach:
• Depression is caused by feelings of loss (real or potential) or of anger directed towards
oneself.
• One psychoanalytic approach suggests that depression is produced by loss of parents
early in life.
• Another psychoanalytic view says that people feel responsible for bad things that
happen to them and direct their anger inwards.
– Some evidence show that bipolar disorder and major depression may have
genetic and biochemical roots. E.g., changes in the functioning of the serotonin
hormones can cause depression.
– Cognitive Approach:
• According to Martin Seligman depression is caused by Learned Helplessness.
• Learned Helplessness is the expectation that things are uncontrollable and cannot be
escaped. Because of learned helplessness people give up effort and submit.
• Another psychologist thinks that depression is caused by hopelessness and learned
helplessness.
• Clinical Psychologist Aaron Beck says that negative cognitions about life events cause
depression.
• Why depression occur twice in women as in men?
– One explanation suggests that women have higher risk for physical and
sexual abuse.
– Earn lower wages.
– Report greater unhappiness with their marriages
– Biological approach says that hormonal changes during the puberty
make women more vulnerable to depression.
– Women taking oral contraceptives, suffer from more depression than
those who are not taking.
 Schizophrenia
• Definition:
– “A class of disorders in which a severe distortion of reality occurs.”
– Thinking, perception and emotions of a person are affected, reduce or
stop interaction and may display bizarre behavior.
• Characteristics of Schizophrenia:
– Decline from previous level of functioning
– Illogical thinking and use of language
– Delusion: (baseless beliefs ) People with schizophrenia think that they
are controlled by someone else, and they cannot hide their thoughts.
– Hallucinations and perceptual disorder: perceiving something that does
not actually exist. People with schizophrenia sense things different from
others.
– Emotional disturbances: Displaying inappropriate emotions at different
occasions.
– Withdrawal from people (reducing interaction with people)
 Types of Schizophrenia
• Disorganized (hebephrenic) Schizophrenia:
– Inappropriate laughter, silliness, incoherent speech, infantile behavior, strange
behavior.
• Paranoid Schizophrenia:
– Delusions, hallucinations, loss of judgment and unpredictable behavior.
• Catatonic Schizophrenia:
– Loss of all motion remaining frozen into single position for hours or hyperactivity
and sometimes violent movement.
• Residual Schizophrenia:
– Minor signs of schizophrenia after a more serious attack.
• Process Schizophrenia:
– Symptoms of schizophrenia develop slowly from early childhood.
• Reactive Schizophrenia:
– The onset of schizophrenia is sudden and conspicuous.
– The treatment of process schizophrenia is difficult as compared to reactive
schizophrenia.
 Causes of
Schizophrenia
• Biological Causes of Schizophrenia:
– Neurotransmitters are the chemicals which allow the transmission of signals from
one neuron (nerve cell) to the next.
– Serotonin is a neurotransmitter. Too little serotonin has been shown to lead to
depression, problems with anger control, obsessive-compulsive disorder, and
suicide. Too little also leads to an increased appetite for carbohydrates (starchy
foods) and trouble sleeping, which are also associated with depression and other
emotional disorders.
– Dopamine and glutamate are other neurotransmitters that cause depression.
• Environmental Causes:
– Faulty communication style according to some psychologists is the major cause
of Schizophrenia.
– Criticism, hostility and emotional disturbance by family members is called
“Expressed Emotion” .
– According to some psychologists Schizophrenia is caused by “Over Attention”
to negative stimuli. Because of over attention, the information processing
capabilities may become overloaded and may eventually break down.
– The “Under Attention” may also cause schizophrenia, the patient may not be
able to concentrate fully on important things and his attention may go towards
un-important or less important things.
 Treatment of
Psychological Disorders
• Psychotherapy:
– A treatment in which a trained professional-a therapist uses
psychological techniques to help someone solve disorders or bring
about personal growth.
– Therapists use 400 different varieties of psychotherapy. Normally all
psychotherapies are based on psychodynamic, behavioral, cognitive,
or humanistic treatments.
• Four Major Approaches for Therapies of Disorders:
1. Psychodynamic Approach
2. Behavioral Approach
3. Cognitive Approach
4. Humanistic Approach
 Psychodynamic
Approach
• Psychoanalytic Therapy:
– “In this therapy, the therapist brings bad experiences from un-conscious into
conscious, so that the patient can deal with it more effectively.”
• Defense Mechanism:
– The defense or fight against bad impulses or thoughts by human.
– One type of defense mechanism is “Repression”, when we press bad
experiences and thoughts in the un-conscious. This repression may later create
anxiety and abnormal behavior called, “Neurotic Symptoms”.
• Free Association:
• The therapists Listens and the patient says loud whatever is coming to his her/her mind
without making sense or logic. This way therapist explores the un-conscious.
• Dream Analysis:
• In this case the therapist examines the dreams of patient in order to know the un-
conscious of the patient.
• Transference:
– The relationship between the therapist and the patient which is formed during the treatment.
The patient may transfer his/her relationship to the Therapist.
– Transference can be used by the therapist to bring good feelings to the patient and remove
bad feelings.
– Traditional Psyhco-analytic Therapy may take from months to years. But current Psycho-
therapists focus on short term treatment not longer than 3 months.
 Behavioral Approach
• Behavioral Therapy:
– According to this approach, both abnormal and normal behavior are learned and
we can reduce abnormal behavior by reinforcement.
– Aversive Conditioning:
– “An unpleasant stimulus is provided to reduce the abnormal behavior.”
– E.g., To avoid alcohol, it is mixed with bad drug that causes vomiting or nausea,
so that the user hats the alcohol next time.
– Systematic Desensitization:
– “Some good stimulus is paired with some bad stimulus, so that anxiety and fear
is minimized.”
– E.g., If you have fear of presentation or flying, so the therapist teaches you
relaxation techniques and then you can go for presentation or flying as you use
the relaxation techniques.
– Observational learning:
– In this treatment, the patient learn directly from the therapist, and the therapist
also rewards the patients.
– Dialectical Therapy:
– In this treatment, the patient is taught to accept who he/she is and if he/she
wants to be happy or un-happy. In this therapy, what you do (behavior), is more
important than your inner feelings.
 Cognitive Approach
• Cognitive-behavioral Approach:
– “A treatment that uses the principles of learning to change the way
people think.”
– E.g., Rational-emotive behavior therapy:
• In this therapy, the patient is taught to restructure a person’s beliefs into
more realistic, rational and logical thinking. This therapy let people eliminate
maladaptive thoughts and beliefs and adopt more effective thinking.

Negative Irrational Belief System Emotional Consequences

(Close relationship (I will never be loved again) (Anxiety, depression)
Break up)

– Beck’s Cognitive Therapy:

• In this therapy, the therapists is helping the patient to discover ways of
thinking that are helpful and discard irrational and wrong ways of thinking.
 Humanistic Approach
• Humanistic Therapy:
– Therapy based on the belief that people have control over there lives and are
responsible for solving their own problems.
– In this therapy, the therapist work as facilitator or guide.
– According to this approach, the disorders are because of inability to find meaning
in life and feeling of loneliness and unconnected to others.
– Non-directive counseling is used in humanistic therapy in which the therapist
does not direct but just asks from the patient, “You feel that”, “Is that it” etc.
– The therapists help the patient to reach self-actualization by providing warm and
caring environment and regard for their feelings and thoughts.
• Group Therapy:
– Group of people meet with therapists to solve their problems.
• Family therapy:
– Therapy focused on family and its dynamics.