LECTURE: 18

Psychological disorders
HOW DOES A MENTAL HEALTH PROFESSIONAL
DEFINE A PSYCHOLOGICAL DISORDER?
 Mental health professionals define a psychological
disorder as condition that either seriously impairs a
person’s ability to function in life or creates a high level
of inner distress (or sometimes both).

 This does not mean that the category “disordered” is

always easy to distinguish from the category “normal”.

 In fact, it may be more accurate to view abnormal

behavior as merely quantitatively different from normal
behavior.
HOW HAS THE VIEW OF PSYCHOLOGICAL
DISORDERS CHANGED OVER TIME?
 Early age: In early societies abnormal behavior was often
attributed to supernatural powers. The roots of a more naturalistic
view can be traced to Hippocrates, who maintained that madness
was like any other sickness, arising from natural causes.

 Middle Age: This approach fell into disfavor in the Middle Ages,
when possession by devils became the predominant explanation
of psychological disorders. A naturalistic view didn’t resurface
until the eighteenth century.

 Modern era: In modern times three approaches have helped to

advance our understanding of abnormal behavior: the biological
, the psychoanalytic, and the cognitive –behavioral.
HOW CAN BIOLOGY INFLUENCE THE
DEVELOPMENT OF PSYCHOLOGICAL DISORDERS?
 The biological model holds that abnormal behavior is
caused by some physiological malfunction, especially of
the brain.

 It is assumed that these malfunctions are often hereditary

in origin.

 Although there is evidence that genetic/biochemical

factors are indeed involved in some psychological
disorders, biology alone can not account for most mental
illness.
WHAT DID FREUD AND HIS FOLLOWERS BELIEVE WAS
THE UNDERLYING CAUSE OF PSYCHOLOGICAL
DISORDERS?

 The psychoanalytic model originating with Freud holds

that abnormal behavior is a symbolic expression of
unconscious conflicts that generally can be traced to
childhood.

 Little scientific evidence supports this theory, however,

even though it has been widely influential.
ACCORDING TO THE COGNITIVE- BEHAVIORAL
MODEL, WHAT CAUSES ABNORMAL BEHAVIOR?
 The cognitive-behavioral model, states that the
psychological disorders arise when people learn
maladaptive ways of thinking and acting. What has been
learned can be unlearned, however.

 Cognitive- behavior therapists therefore strive to modify

their patients’ dysfunctional behaviors and distorted,
self-defeating processes of thought.
WHY DO SOME PEOPLE WITH A FAMILY BACKGROUND
OF A PSYCHOLOGICAL DISORDER DEVELOP THE
DISORDER WHILE OTHER FAMILY MEMBERS DO NOT?

 The diathesis-stress model is one promising approach to

answering this question.

 As an attempt to integrate the biological perspective

with environmentally based ones, it holds that
psychological disorders develop when a diathesis (or
biological predisposition) is set off by stressful
circumstances .
CONTD.
 Another attempt at integrating causes is the systems
approach. It contends that psychological disorders are
“lifestyle diseases” that arise from a combination of
biological risk factors, psychological stresses, and
societal pressures on people.

 This approach too can help to explain why a family

background of a disorder doesn’t always mean that the
disorder will develop.
WHY IS IT USEFUL TO HAVE A MANUAL
OF PSYCHOLOGICAL DISORDERS?
 For nearly 40 years the American Psychiatric Association had published the
Diagnostic and Statistical Manual of Mental Disorders (DSM).

 Latest updated in 2013.

 The current Fifth edition , known as DSM-V, provides careful descriptions of

symptoms of different disorders so that diagnoses based on them will be
reliable from one mental health professional to another.

 There are not many differences between DSM-5 and its earlier edition DSM-4

 Critics however, assert that, for example, that many DSM-5 revisions or
additions lack empirical support; inter-rater reliability is low for many
disorders; several sections contain poorly written, confusing, or contradictory
information; and the psychiatric drug industry unduly influenced the manual's
content. 
HOW DO MOOD DISORDERS DIFFER
FROM ORDINARY MOOD CHANGES?
 Most people have a wide emotional range, but in some
people with mood disorders this range is greatly
restricted. They seem stuck at one or the other end of the
emotional spectrum.

 The most common mood disorder is depression , a state

in which a person feels overwhelmed with sadness, loses
interest in activities, and displays other symptoms, such
as excessive guilt or feelings of worthlessness.
HOW DOES CLINICAL DEPRESSION
DIFFER FROM ORDINARY SADNESS?
 The DSM-IV distinguishes between two forms of
clinical depression. Major depressive disorder is an
episode of intense sadness that may last for several
months.

 In contrast dysthymia involves less intense sadness but

persists with little relief for a period of 2 years.
WHY DOES MANIA, WHICH IS GENERALLY
CHARACTERIZED BY A HIGH LEVEL OF ACTIVITY,
PRODUCE VERY FEW CONSTRUCTIVE OUTCOMES?
WHAT IS BIPOLAR DISORDER?
 People suffering from mania become euphoric (“high”),
extremely active, excessively talkative, and easily
distractible. They typically have unlimited hopes and
schemes but little interest in realistically carrying them
out. At the extreme they may collapse from exhaustion.

 Manic episodes rarely appear by themselves ; rather, they

usually alternate with depression.

 Such a mood disorder , in which both mania and

depression are alternately present, sometimes interrupted
by periods of normal mood, is known as bipolar disorder.
WHAT CAUSES SOME PEOPLE TO EXPERIENCE
EXTREME MOOD CHANGES?
 Mood disorders can result from a combination of biological,
psychological, and social factors.

 Biological factors– including genetics and chemical imbalances in

the brain –seem to play an important role in the development of
depression and especially bipolar disorder.

 The Psychological factor of cognitive distortions(unrealistically

negative views about the self ) occurs in many depressed people,
although it is uncertain whether these distortions cause the
depression or are caused by it.

 Finally social factors such as troubled relationships have also been

linked with mood disorders.
HOW DOES AN ANXIETY DISORDER
DIFFER FROM ORDINARY ANXIETY?
 Normal fear is caused by something identifiable, and the
fear subsides with time. In the case of anxiety disorder,
however, either the person doesn’t know why he or she is
afraid or the anxiety is inappropriate to the
circumstances.
HOW DOES A PHOBIA DIFFER FROM
FEAR?
 A specific phobia is an intense, paralyzing fear of
something that it is unreasonable to fear so excessively.

 A social phobia is excessive, inappropriate fear

connected with social situations or performances in front
of other people.

 Agoraphobia is less common and much more

debilitating type of anxiety disorder that involve
multiple, intense fears such as the fear of being alone or
of being in public places or other situations that require
separation from a source of security.