Chapter 13: Mental Health Disorders
Distinguishing Abnormal from Normal
Psychology typically uses several criteria to define abnormality
Behaviors that are not typical or culturally expected- a statistically infrequent
event; behaviors or situations that are uncommon or rare, or inconsistent with
the context in which they occur
Distress- personal suffering or a sense of emotional discomfort with a given
situation or set of symptoms
Dysfunction- when a person’s symptoms interfere with their ability to fulfill the
expected roles or responsibilities of their life
Explaining Abnormal Behavior: Perspectives Revisited
Biological theories examine genetic influences and physical changes operating
from a medical (or illness) model
Psychological models include the psychoanalytic, social learning, cognitive, and
humanistic perspectives.
Sociocultural models focus on the contextual situations and conditions that can
lead people down the road of unhealthy psychological functioning. As one
example this approach might consider the influence of poverty on mental well
being
An integrative model called the biopsychosocial model integrates all of these,
looking at mental health disorders through a wider lens that considers the
simultaneous effect of many influences
DSM
Released in its latest edition in 2013, the Diagnostic and Statistical Manual of
Mental Disorder, fifth edition (DSM-5) is a book that catalogues over 300
diagnosable mental health disorders and their symptoms divided into 20 major
categories. It also includes conditions to be researched for future editions
Bear in mind that DSM-5 is not a treatment guide and offers no information
about how to treat these conditions. It also does not give information about the
cause of these disorders that is, it is a theoretical nature
Components of Excessive Anxiety
Anxiety disorders include conditions that involve chronic disruptive worry, fear, or
apprehension that would be considered culturally unexpected
The physical components of anxiety include dizziness, elevated heart rate and
blood pressure, muscle tension, sweaty palms, and dry mouth
o These physical symptoms stem from the activation of the sympathetic
nervous system
Cognitive components of anxiety many include worrying, fearing loss of control,
exaggerating (in one’s mind) the danger of a situation, exhibiting paranoia, or
being extremely wary and watchful of people and events
Emotional reactions like a sense of dread, terror, panic, irritability, or
restlessness. These thought and emotions propel the person to behave in ways
meant to cope with the anxiety
All lead to behaviors: such as escaping of fleeing from the situation aggressively
freezing which results in being unable to move or avoiding the situation in the
future
Anxiety disorders identified in the DSM include phobias, generalized anxiety
disorder, and panic disorder:
Generalized anxiety disorder includes an extended period of free-floating anxiety
that is not tied to any one trigger. They seem to worry about everything but
cannot place their finger on what it is that has them upset or concerned.
Panic disorder is marked by sudden and overwhelming attacks (panic attacks) of
dread and worry that are accompanied by physical symptoms that mirror a heart
attack. They can lead to a vicious cycle of worrying about the next attack which,
in turn, can trigger an attack.
Phobias (or phobic disorders) are intense and irrational fears that center around a
specific trigger (specific phobia). The dysfunctional nature of phobias often lies in
the fact that they lead to pathological avoidance of the trigger, which in many
cases can be very disruptive. Phobias can also involve social anxiety disorder
(social phobia) and agoraphobia (which may be attacked to panic attacks as well).
Types of Excessive Anxiety Disorders
Obsessive-compulsive disorder (ODC) includes repeating, intrusive thoughts that
increase anxiety (obsessions) which are often followed by repetitive ritualistic
behaviors (compulsions) that feel like they are venting that anxiety
Hoarding disorder: which is when a person focuses obsessively on acquiring and
keeping possessions even those with very little value. They find disposing of
objects psychological painful if not impossible and often collect so much that
their living space becomes untenable
Post-traumatic stress disorder (PTSD) occurs in some people after exposure to a
particularly frightening or dangerous event, often one in which death or serious
injury was possible. PTSD is a major problem for those who have been victimized
and is also often seen in soldiers who return from combat
Research Explaining Anxiety, Obsessive Compulsive and Trauma- Related Disorders
Biological factors: neurotransmitters and genetic factors have been identified in
many anxiety, obsessive-compulsive, and trauma-related disorders. In addition,
specific brain areas have also been identified as showing abnormal structure or
activity
Psychological factors: the primary emphasis in this set of symptoms has looked at
cognitive processes (how we think about given situations) and learning (the
behaviors that we acquire through typical learning processes most notably
classical and operant conditioning and modeling)
Sociocultural factors: what do you think is the influence of poverty, sex and
gender, race and ethnicity, and other cultural factors on anxiety? As an example,
if people in low SES communities have a hard time making ends meet and taking
care of their basic needs, might they be more included to experience chronic
worry that could develop into one of these diagnoses?
Dissociative Disorders
Disruptions in memory, consciousness, or identity typify dissociative disorders
which take
Dissociative identity disorder (formerly called multiple personality disorder)
includes the development of two or more identities in the same individual. It is a
highly controversial
Somatic Symptom Disorders: Doctor I’m Sure I’m Sick
Somatic symptom disorders (and their related diagnoses) occur when physical
symptoms appear that have no identifiable physical cause
Illness anxiety disorder involves ongoing worry about fear and about having or
developing a physical illness. It was previously referred to as hypochondriasis.
Some people with this condition constantly visit physicians while others believe
they are ill but refuse to do so
Clearly diagnosing these problems is complicated as it is important that we do
not assess true physical problems as psychological nature. They also do not
reflect a person faking symptoms but rather
Depressive Disorders: A Change to Sadness
Depressive disorders, including major depressive disorder, involve extended
periods of intense sadness, hopelessness, and a lack of ability to take pleasure in
previously enjoyed activities. Physical and cognitive symptoms also accompany
this disorder. They can emerge in response to external events or show up for no
discernable reason whatsoever
When the disorder is less severe but much longer lasting it is called persistent
depressive disorder (formerly called dysthymic disorder)
Depressive disorders are among the most commonly diagnosed of all
psychological conditions and are typically severe enough to warrant significant
therapeutic intervention although many who suffer never receive the help that
they need
Bipolar-Related Disorders: The Presence of Mania
Those with bipolar disorder experience both periods of depression as well as
mania
Mania: is sometimes thought of as the opposite of depression, is an elevated,
active emotional state
When the depression and manic states occur with longer duration but slower
severity, a diagnosis if cyclothymia might be made
You might think cyclothymia as being related to bipolar disorder in the same way
that persistent depressive disorder is related to major depressive disorder
Research Explaining Mood Disorders
Biological factors- both depression and bipolar disorders (especially bipolar
diagnoses) seem to run in families, suggesting a genetic contribution. Specific
genes have been identified that may be related to these conditions. Researchers
have also focused on specific brain structures, as well as changes in
neurochemical functioning and stress hormones. This information has allowed
experts to craft medications that may alter (or restore normal) functioning in
these areas
Psychological and social factors- even if genetic factors are not relevant these
diagnoses may still be seen in family members because of shared environmental
influences. Exposure to problematic early life experiences as well as a cognitive
style of learned helplessness contributes to mood disorder symptoms
A number of sociocultural contributors have been suggested including social
isolation anxiety and negative thinking processes as well as ethnicity sex and
sexual orientation
Schizophrenia
Schizophrenia typical appears in the late teens or early adult years and is rather
uncommon in childhood or later adulthood. The onset is typically somewhat later
in women than in men. It is diagnosed more in African American and Asian
American individuals but as with the discussion of depression and gender we
have to wonder if this reflects true incident differences or cultural factors
A prevailing myth about schizophrenia is that it is untreatable, but that is highly
inaccurate. Most with this condition can receive effective treatments that
significantly reduce symptoms and improve overall functioning
Symptoms of schizophrenia are divided into pathological excessed (positive
symptoms) and deficits (negative symptoms)
Positive symptoms include delusions, hallucinations disorganized speech, and
disordered behaviors
Negative symptoms include blunted, inappropriate, or flat affects or poverty of
speech and avolition
