Unit 8: Clinical Psychology

Abnormal Behavior III

Notebook Page 31
 Schizophrenia
Schizophrenia is another disorder that is often misunderstood.
Contrary to popular belief, schizophrenia does not involve multiple
personalities, but rather, schizophrenia is a split from reality.
This means that your brain operates in the real world and in its
own world. Schizophrenic patients may experience hallucinations –
false sensory experiences, such as visual, touch, or auditory –
that are drawn specifically from internal interpretation. Simply
speaking, this means there is no abnormal external stimuli. Patients
are hearing or seeing things that are not there.

Additionally, they may experience delusions – or false beliefs and perceptions that are often grand or
persecutional. While there is no false sensory information, the problem is perceptual. Those suffering from
delusions often feel paranoid, believing people or groups are out to ruin, harm, or kill them. They may also
suffer from grandiose delusions and believe they are things they are objectively not. For example, a
schizophrenic patient may believe they are a spy, secret agent, the President of the United States, owner of
Microsoft, etc. Externally, they may also show signs such as disorganized thinking in speech, and diminished
or inappropriate emotions. These inappropriate emotions can manifest themselves as reversed emotions (such
as laughing at a funeral), emotional flatness, or trouble reading the emotions of others.
 Continued
Schizophrenia comes into two primary forms: chronic and acute. Chronic
schizophrenia sets in slowly over time whereas acute schizophrenia has
a more sudden onset due to stressors. While both cases are maladaptive
and can vary in severity, acute is far more likely to be remedied. Often with
time, therapy, and a reduction in stressors, acute can fade. Chronic, on the
other hand, is generally permanent. While it does set in slowly, those who
begin to show signs of chronic schizophrenia (often in their teens) slowly
progress down a worsening road. Regardless of being acute or chronic,
schizophrenic patients are often distracted by stimuli and unable to focus due the presence of their hallucinations, delusional thoughts,
or overly-active neural activity. In severe cases, schizophrenia may result into psychosis – irrationality and a loss of contact with reality,
and often results in institutionalization as patients may be a danger to themselves or others.

Recently psychologists have developed the schizophrenia spectrum to better capture the coexistence of subtypes the five subtypes:
catatonic, disorganized, paranoid, residual, and undifferentiated as opposed to its existing as individuals and groups

Biological Causes
While the exact causes of schizophrenia are unknown, and there are many interacting factors, there are several biological causes and
factors that can predispose one for schizophrenia. For example, most schizophrenia patients have, on average, 6 times the amount
dopamine-4 receptors. This is believed to result in an overstimulation of neural activity and possibly cause or contribute to the presence
of hallucinations and/or delusions. Regarding brain structure, schizophrenic patients also showcase diminished frontal lobe activity (the
areas responsible for logic and judgment) and there is often some abnormal fluid buildup and shrinkage in various parts of the brain.
Maternal viruses also seem to increase risk of schizophrenia (1% to 2%), and 1 in 100 odds jump to 1 in 10 if one parent is schizophrenic
 Dissociative Disorders
Dissociative disorders are disorders in which conscious awareness
becomes separated from previous memories, thoughts, and feelings.
These are often involuntary escapes from reality and can result in a
sudden loss of memory or identity, often under stress. Half of all adults
report experiencing times where they felt dissociated from themselves,
others, or a particular situation. Regardless, only 2% of adults qualify
for a fully-fledged diagnosis.

The disorder that is commonly confused or incorrected associated with schizophrenia is dissociative
identity disorder (DID). Also known colloquially as multiple personality syndrome, DID is a disorder in
which two or more distinct identities are said to alternate control of the person’s behavior. People may go
from being predominately prim and proper to loud and flirtatious or calm and collected to angry and
aggressive. Psychologists question if the disorder is real or an extension of our normal personality shifts,
as we can act differently in different situations or while affected by different moods. There is also some
question as to the validity of DID claims as only a handful of cases existed in the United States prior to its
popularization by Hollywood films. After its popularity soared, so too did DID diagnoses which remain
incredibly low outside of the U.S. (another indicator that it may be a pseudo disorder).
 Personality Disorders
One may also suffer from a personality disorder – a disorder
characterized by inflexible and enduring patterns of behavior
that impair social functioning. These are disorders that make
it difficult to interact and form relationships with others. One of
the most popular personality disorders is antisocial personality
disorder – a disorder that consists of a lack of conscience or
wrongdoing, even towards family and friends. People are often
most familiar with two variants of antisocial personality disorder:
psychopathy and sociopathy.

Psychopaths and sociopaths both exhibit similar symptoms: a diminished or absent conscience or regard for others, as
well as a disinhibited ego. The primary difference between psychopaths and sociopaths is that psychopaths are born
with a lack of emotional connection, and sociopaths are desensitized over time—in sum, psychopaths are born and
sociopaths are made. Psychopaths often exhibit early symptoms of psychopathy, such as a lack of remorse or
enjoyment in inflicting harm on others, killing small animals for fun, etc. Sociopaths, on the other hand, often lead
normal childhoods and the symptoms can begin to set in during adolescence or early adulthood. Those experiencing
antisocial personality disorder may be aggressive and ruthless, or clever, charismatic con artists that are able to lie,
manipulate, and steal without any guilt or tell-tale signs of lying. One percent of the population are born psychopaths,
and 3% of the population eventually becomes a sociopaths. Psychopathy and sociopathy are far more common in
males, but rare regardless.
 Eating Disorders

In the latest edition of the DSM, hoarding and eating disorders were added. Many blame socio-cultural
factors, such as the emphasis on weight and physique, for the rise in eating disorder diagnoses. One of
the most common eat disorders is anorexia nervosa. Anorexia nervosa is essentially when one diets and
exercises to the point of an unhealthy low weight/body mass index. It usually begins with a weight-loss
diet (which can be healthy), but drifts into the realm of a disorder when subjects begin to obsess about
losing weight and see themselves as ‘fat’ despite being underweight. Another common eating disorder is
bulimia nervosa – cycles of binge eating and purging food. Not only can bulimia nervosa damage one’s
esophagus and teeth due to overexpose to stomach acid, but the disorder often also results in depression.

Of additional concern is another complex known as binge-eating disorder.

Binge-eating disorder is when a person goes through cycles of binge-eating
and weight gain for extended periods and then engages in heavy diet and
exercise afterward due to the stress or depression induced by binging.
Regardless of the particular eating disorder, they all have notable negative
physical, emotional, and cognitive consequences.
 Neurodevelopmental Disorders
Neurodevelopmental disorders are disorder that affect brain development and inhibit emotional
regulation, learning ability, self-control, and memory. Such disorders occur as one develops and grows
and, whether caused by genes or the environment, are generally irreversible. Most neurodevelopmental
disorders are visible during childhood and adolescence. The problem with neurodevelopmental disorders
is that once the brain has formed abnormally or missed developmental critical periods, the skills or repair
necessary cannot be completed. Some common examples of neurodevelopmental disorders are
intellectual disability, autism spectrum disorder, communication or speech disorders, etc.

The causes of neurodevelopmental disorders can be genetic

or environmental, as, in either case, there is an interference
with normal brain development. Genetically, disorders like
autism spectrum disorder, intellectual disability, Down syndrome,
and other DNA/chromosomal disorders are inherited from parents.
Conversely, epigenetic effects can result in environmental
interference in brain development, as well as deprivation from
social and emotional connection (i.e., not receiving affection and
attention in one’s childhood) may also severely delay and interfere
with cognitive development.
 Neurocognitive Disorders
Neurocognitive disorders are essentially the opposite of
neurodevelopmental disorders. While neurodevelopmental
refer to errors in brain developmental, neurocognitive disorders
are deterioration of the brain due to old age or a genetic
disorder. Patients suffering from neurocognitive disorders
experience the deterioration of neurons (grey and white matter)
in the brain that affect memory and functioning. Deterioration
of neurons may also extend to the central and peripheral nervous
systems affecting our sensory and motor neurons. Neurocognitive diseases are, therefore, not necessarily
a disease one can become infected with but are rather a decline in neural precision, performance, and
function. Some prominent examples of neurocognitive disorders are Alzheimer’s Disease (the loss of
memory and normal brain functioning), Parkinson’s Disease (the degeneration of motor neurons and
bodily control), and Huntington’s Disease (problems with mood regulation or mental abilities).
 Explanations for Disorders
There are several different explanations for psychological disorders from the various fields of psychology.
While there is no single cause or solution to all psychological disorders, the theories and explanations for
psychological disorders from the various fields do have merit in at least some psychological disorders.
Psychoanalytic psychologists believe the causes for psychological disorders lie in the unconscious
fears/anxieties of patients, such as in the case of somatic symptom disorders that have no clear physical
causes or cognitive problems. Cognitive psychologists tend to prefer explanations centered around how
cognition and thinking can interfere with biology and behavior, such as in the case of rumination and
pessimism causing or prolonging depression. Sociocultural psychologists tend to favor explanations
centered around the impact of one’s societal and cultural pressures or limitations. For example,
sociocultural psychologists assert that popularity and culture can have an impact on diagnosis, such as the
increased diagnoses of DID and prevalence of eating disorders in the United States.
 Legal System
Another complication with psychological disorders comes with the application of common law to people suffering from
psychological disorders. There has been some debate as to whether or not laws should apply to psychological disorder
patient who may or may not have reasonable control of their behavior when suffering from a disorder. The exception to
regular litigation is a concept known as the insanity defense - a defense by excuse in a criminal case, arguing that the
defendant is not responsible for their actions due to an episodic or persistent psychiatric disease at the time of the
criminal act. Essentially, attorneys request alternative consequences such as medical treatment, therapy, probation, or
institutionalization rather than prison time due to the fact that the defendant did not or does not have normal control of
their thoughts or actions.

Aside from assessing the validity of the defendant’s claim, there are
other legal complications. If one is determined to have a psychological
disorder, they can be excluded from business contracts or wills. There
is also the issue of confidentiality, as, according to HIPAA, medical
information (both mental and physical) is confidential by law. In a court
case, confidential psychological reports (and sometimes even raw data,
if mandated by court order) are circulated between attorneys and other
parties involved in the case. Such information may even be referenced
in the media if a trial is covered. These labels can be damaging to the
reputation of the defendant, and, as shown in the Rosenhan and pseudo
cancer patient study, affect the perception of others regarding one who suffers from a psychological disorder.