CHAPTER 4

PSYCHOLOGI
CAL
DISORDERS
CLASS XII
* When the behaviours cannot be
modified according to the situation
it is called maladaptive.

* Abnormal Psychology study the

maladaptive behaviour- its causes,
consequences and treatment
FOUR D’S TO DEFINE
ABNORMALITY
* Deviance: extreme , unusual , bizzare.

* Distress: unpleasant and upsetting to the

person and to the others.

* Dysfunctional: interfering with persons

ability to carry out daily activities in a
constructive way.

* Dangerous: to the person or to others.

APPROACHES USED TO DEFINE
NORMAL AND ABNORMAL BEHAVIOUR

* First approach view Abnormal Behaviors as

deviation from social norms.

* Second approach view abnormal behaviour

as maladaptive. This approach views
behaviours as fostering the well being of the
person and eventually to the group to which
she belong. Well being not only involves
maintainance and survival but also includes
growth and fulfillment.
STIGMA

The stigma attached to the mental

illness means that people are hasitant
to consult a doctor or psychologist
because they are ashamed of their
problem.
HISTORICAL BACKGROUND
1. Supernatural and magical forces: evil
spirit (bhoot- pret), devil (saitan)

* Exorcism: removing the evil that resides in the

individual through counter magic and prayer

* In many societies the shaman or the medicine

man Ojha is the person who is believed to have
contact with the supernatural forced and is the
medium through which spirits communicate to
the human being
2. Biological and organic Approach :

* It believed that body and brain are not

working properly.

* For certain type of disorders, correcting

these defective biological process
results in improved functioning
3. Psychological Approach

* Psychological problem are caused by

inadequacies in the way an individual
think, feels, or perceive the world
4. ORGANISMIC APPROACHED

 Developed by philosopher-physician of Ancient

Greece such as Hippocrates, Socrates and Plato.

 Viewed disturbed behaviour as arising out of

conflicts between emotions and reasons.

 Galen elaborated on Four Humours .i,e, material

world is made up of four elements: earth, air,
fire, water which combine to form four essential
body fluid I,e, blood, black bile, yellow bile and
phlegm.
* Each of these fluids were seen to be
responsible for a different
temperament.

* Imbalance in the humours cause

various disorders.

* This is similar to three doshas of vata,

pitta, kapha mentioned in Atharva
Veda an Ayurvedic Text.
5. The Middle Age:
Demonology and Superstition gained
Importance.

6. The Renaissance Period:

* Increased Humanism and curiosity about
behaviour

* Johann wayer emphasized psychological

conflicts and disturbed interpersonal
relationships are cause of psychological
disorders.
7. AGE OF REASON AND ENLIGHTENMENT:

* Seventeenth and eighteenth century

* Scientific method replaced faith and
dogma
* Reform Movement as an increase
compassion towards people with
mental disorders.
* Deinstitutionalisation which placed
emphasis on providing community care
for recovery of mentally ill individuals.
8. Interactional or Bio-
psycho-social approach:
Three factors play important role in
influencing the expression and
outcome of psychological disorders
CLASSIFICATION OF PSYCHOLOGICAL DISORDERS

* The American Psychiatric Association (APA) has

published a manual describing and classifying
various kinds of psychological disorders.

* The Diagnostic and Statistical Manual of

Mental Disorders V Edition (DSM V) evaluate
the patient on five axes or dimensions.

* The classification scheme used in India and

elsewhere is International Classification of
Diseases ( ICD 11) which is known as ICD 11
Classification of Behavioural and Mental
Disorders. It was prepared by World Health
Organisation.
FACTORS UNDERLYING ABNORMAL
BEHAVIOUR
1 Biological Factors:
* Faulty genes , endocrine imbalance, malnutrition,
injuries etc may interfere with normal development
and functioning of human development.

*Biological research found that psychological

disorders are often related to problems in the
transmission of messages from one neuron to
another.

*When an electrical impulse reaches a neuron’s

ending the nerve ending is stimulated to release a
chemical called neurotransmitter.
*Abnormal activity of these
neurotransmitter lead to Psychological
disorders.
For example:
Anxiety disorder – gamma
aminobutyric acid (GABA)
Schizophrenia- Excess activity of
Dopamine
Depression – low activity of
serotonin.
2. Genetic factor:
* Linked to Mood disorder,
schizophrenia, mental retardation .
3. PSYCHOLOGICAL MODEL:

• Psychological and interpersonal factors have a

significant role to play in abnormal behaviour.

• For example:

Maternal deprivation (separation from the

mother or lack of warmth and stimulation during early
years of life)
Faulty parent-child relationships ( rejection,
overprotection, over permissiveness, faulty discipline)
Maladaptive family structure (inadequate or
disturbed family)
Severe stress
PSYCHODYNAMIC MODEL:

* Whether normal or abnormal is determine

by the psychological factors within the
person, of which he /she is not consciously
aware.

* Internal factors interact with one another

and their interactions give shape to
behaviour, thought and emotions.

* Abnormal forces are result of conflict

between these forces.
BEHAVIOURAL MODEL:

* Both normal and abnormal behaviours

are learned and psychological
disorders are result of learning
maladaptive behaviours.

* Behaviours are learned through

conditioning and what is learned can
be unlearned.
COGNITIVE MODEL:

* People may hold assumptions and

attitude about themselves which are
irrational and inaccurate.

*people may also repeatedly think in

illogical ways and make
overgeneralizations i.e., they may draw
negative conclusions on the basis of
single insignificant events
HUMANISTIC- EXISTENTIAL MODEL:

*Believe that from birth we have total

freedom to give meaning to our
existence or to avoid that responsibility.

* Those who shrink from responsibility

would live empty, inauthentic and
dysfunctional lives
4. SOCIO – CULTURAL MODEL:

* Family members are over involve in

each others activity---- difficulty in
becoming independent in life.

*Isolated and lack of social support----

depressed

* Societal role and label assigned to

people----- such labels stick to that
person
5. DIATHESIS – STRESS MODEL:

*Psychological disorders are developed when

diathesis( biological predisposition to the
disorder) is set off by a stressful situation.

*Three components:
1. Diathesis or the presence of some biological
aberration which is inherited.
2. Diathesis may carry a vulnerability to develop
a psychological disorder.
3. Presence of pathogenic stressors i.e., factors
that may lead to psychopathology.
ANXIETY DISORDER
 Symptoms:
 The term anxiety Rapid heart rate,
is defined as
shortness of breath,
diffuse, vague,
dizziness,
very unpleasant
loss of appetite,
feeling of fear
fainting,
and
sweating,
apprehension.
sleeplessness,
frequent,
urination and tremors.
TYPES OF ANXIETY DISORDER

Generalized Anxiety
Disorder
Panic Disorder
Phobias
SAD
GENERALIZED ANXIETY DISORDER:

Prolonged, vague, unexplained and intense fears

that are not attached to any particular object .

 Symptoms:

1.Worry
2. Apprehension feeling about the future,
3. Hyper vigilance
4. Constant scanning the environment for danger
5. Motor tension as a result of which the person is
unable to relax, is restless and visibly shaky and
tense.
PANIC DISORDER

Recurrent anxiety attacks in which the

person experience intense terror

 Symptoms: 6.Nausea
1.Shortness of 7.Chest pain
breadth 8.Fear of going crazy
2.Dizziness 9. losing control or
3.Trembling dying
4.Palpitation
5.Choking
PHOBIAS
Irrational fear related to specific
object , people or situations.

 Types of Phobia:
Specific Phobia
Social Phobia
Agoraphobia – Unfamiliar
situation
SEPARATION ANXIETY
DISORDER (SAD):

Children with SAD may have difficulty

being in a room by themselves, going
to school alone, are fearful of entering
new situations, and cling to and
shadow their parent’ every move.
OBSESSIVE-COMPULSIVE DISORDER
Unable to control their preoccupation with specific
ideas or are unable to prevent themselves from
repeatedly carrying out a particular act or series
that affect their ability to carry out normal
activities.

Obsessive behaviour is the inability to stop

thinking about particular idea or topic. Often find
these thoughts to be unpleasant and shameful.

Compulsive behaviour is the need to perform

certain behaviours over and over again. Example
- counting, checking, touching, washing.
TRAUMA AND STRESS RELATED
DISORDER.
POST TRAUMATIC STRESS DISORDER (PTSD)

 Symptoms
1. Recurrent dreams
2. Flashback
3. Impaired concentration
4. Emotional numbing

 Adjustment Disorders and Acute Stress Disorder

are also included under this category.
SOMATIC SYMPTOMS AND RELATED DISORDER

 Somatic symptom disorder

 Illness anxiety disorder

 Conversion disorders

Physical symptoms in the absence

of physical disease.
SOMATIC SYMPTOM DISORDER

People with this disorder tend to be overly

preoccupied with their symptoms and they
continually worry about their health and
make frequent visits to doctors.
ILLNESS ANXIETY DISORDER

It involves persistent preoccupation

about developing a serious illness and
constantly worrying about this possibility
CONVERSION DISORDER
* Report loss of part or all of some
basic body functions.
Paralysis
Blindness
Deafness
Difficulty in walking
* Occurs after a stressfull situation or
sudden
DISSOCIATIVE DISORDER
*Dissociation involves feeling of unreality, estrangement,
depersonalization and sometimes a loss or shift of
identity.

*Sudden temporary alterations of consciousness that blot

out painful experiences are defined characteristics of
dissociation.

* TYPES:
1. Dissociative amnesia
 Dissociative fugue
2. Dissociative identity disorder
3. Depersonalisation
DISSOCIATIVE AMNESIA
* Excessive but selective memory loss
that has no organic cause (head
injury).
* Some people cannot remember
anything about the past
*Some no longer recall specific events,
people, places etc while their
memory for others remain intact
* Associated with overwhelming stress
 DISSOCIATIVE FUGUE

* Unexpected travel away from

home and workplace.
* Assumption of a new identity.
* Inability to recall their previous
identity.
DISSOCIATIVE IDENTITY DISORDER

* Referred to as multiple personality

disorder.

*Associated with traumatic experience in

childhood.

* Assumes alternate personalities that

may or may not be aware of each other.
DEPERSONALIZATION

Dreamlike state in which the

person has a sense of being
separated both from self and
from reality.
DEPRESSIVE DISORDERS

Disturbance in mood or prolonged

emotional state.

TYPES:
Depression
Major depressive disorder
DEPRESSION
* Depression covers variety of negative mood
and behavioural changes
* Factors predisposing towards depression:
 Genetic make up or heredity
 Age ( women-young adulthood, men-
middle age)
 Gender ( women report more)
 Experiencing negative life event
 Lack of social support
MAJOR DEPRESSIVE DISORDER
Period of depressed  Inability to think
mood or lose of clearly
interest or pleasure  Agitation
in most activities  Greatly slowed
together with other behaviour
symptoms such as:  Though of death and
suicide
 Change in body  Excessive guilt
weight feeling
 Constant sleep  Feeling of
problem worthlessness
 Tiredness
BIPOLAR RELATED DISORDERS
 Bipolar I disorder: It involves both mania
and depression. Bipolar mood disorders were
earlier referred to as manic-depressive
disorders.
 Some examples of types of bipolar and
related disorders include Bipolar II disorder
and Cyclothymic Disorder.
 Suicide is a result of complex interface of
biological, genetic, psychological,
sociological, cultural and environmental
factors
SOME MEASURES SUGGESTED BY WHO TO
PREVENT SUICIDE INCLUDES :

 Limiting access to the means of suicide;

 Reporting of suicide by media in a
responsible way;
 Bringing in alcohol-related policies;
 Early identification, treatment and care of
people at risk;
 Training health workers in assessing and
managing for suicide;
 Care for people who attempted suicide and
providing community support.
HOW CAN WE IDENTIFY STUDENTS IN
DISTRESS?

 Lack of interest in common activities

 Declining grades
 Decreasing effort
 Misbehavior in the classroom
 Mysterious or repeated absence
 Smoking or drinking, or drug misuse
IN ORDER TO FOSTER POSITIVE SELF- ESTEEM IN CHILDREN
THE FOLLOWING APPROACHES CAN BE USEFUL:

 Accentuating positive life experiences to

develop positive identity. This increases
confidence in self.
 Providing opportunities for development of
physical, social and vocational skills.
 Establishing a trustful communication.
 Goals for the students should be specific,
measurable, achievable, relevant, to be
completed within a relevant time frame
SCHIZOPHRENIC DISORDER
Schizophrenia is a descriptive term
for a group of psychotic disorders
in which personal, social and
occupational functioning
deteriorates as a result of disturbed
thought processes, strange
perception, unusual emotional
states and motor abnormalities.
SYMPTOMS OF SCHIZOPHRENIA
 Positive
symptoms: these are ‘
pathological Excess’ or ‘ bizarre
addition’ to the persons behaviour .
Excess of thought , emotions and
behaviour

 Negative symptoms: Deficit of

thought , emotions and behaviour

 Psychomotor symptoms
POSITIVE SYMPTOMS
1. Delusions: False belief that is firmly held on inadequate grounds.

Types

 Delusion of persecution : believe that they are being plotted

against, spied on, slandered, threatened , attacked, or deliberately
victimized.

 Delusions of reference : attach special and personal meaning to

the actions of others or to objects and events.

 Delusions of Grandeur: believe themselves to be specially

empowered persons .

 Delusions of control: believe that their feelings , thoughts and

actions are controlled by others
2. FORMAL THOUGHT DISORDERS:

* People with schizophrenia may not think logically

and may speak in peculiar way. This can make
communication extremely difficult.
• These includes :

 Rapidly shifting of one topic to another so that

normal structure of thinking is muddled and
become illogical ( loosening of association,
derailment)

 Inventing new words or phrases (neologisms) .

 Persistent and inappropriate repetition of the same

3. Hallucination : perception that occurs in
the absence of external stimuli
Types of Hallucination:
• Auditory hallucination

* Second person hallucination: person hears

sounds , voices that speak words , phrases
and sentences directly to the patient

* Third person hallucination: talk to one

another referring to the patient as s/he
Tactile hallucination : forms of tingling ,
burning
Somatic hallucination: something happening
inside the body such as snake crawling
inside one’s stomach
Visual hallucination: vague perception of
colours or distinct vision of people or object
Gustatory hallucination : food or drink taste
strange
Olfactory hallucination : smell of poison or
smoke
4. Inappropriate affect: emotions
that are unsuited to the situation
NEGATIVE SYMPTOMS
‘ Pathological deficits’ are included in poverty of speech,
blunted and flash affect, loss of volition, and social
withdrawal.

Types :-

 Alogia or poverty of speech: reduction in speech and

speech content
 Blunted affect: less anger, sadness, joy and other feelings
than most people do.
 Flat affect: no emotion at all.
 Avolition: inability to start or complete a course of action

People with this disorder withdraw socially and becomes

totally focused on their own ideas and fantacies.
PSYCHOMOTOR SYMPTOMS
Catatonia: move less spontaneously
or make odd grimaces and gestures
Catatonic stupor: remain motionless
and silent for strong stretches of
time
Catatonic rigidity: maintaining rigid
posture for hours.
Catatonic posturing: assuming
awkward, bizarre positions for long
periods of time
SUB TYPES OF SCHIZOPHRENIA
Paranoid type: preoccupied with delusion or
auditory hallucination, no disorganized speech or
behaviour or inappropriate affect.
Disorganized type: disorganized speech and
behaviour, inappropiate or flat affect , no
catatonic symptoms.
Catatonic type: extreme motor immobility,
excessive motor inactivity, extreme negativism or
mutism.
Undifferentiated type: does not fit any of the
subtypes but meets symptoms criterion.
Residual type: has experienced at least one
episode of schizophrenia , no positive symptoms
but show negative symptoms
NEURODEVELOPMENTAL DISORDER

 They manifest in the early stage of

development.

 Deficits or excesses in a particular

behaviour or delays in achieving a
particular age-appropriate behaviour.
1. ATTENTION – DEFICIT HYPERACTIVE
DISORDER (ADHD):

Two main features are inattentive and

Hyperactivity-impulsivity.

Common  Disorganized
complaints for  easily distractible
inattentive :  Forgetful
 Cannot  Does not finish
concentrate assignment
 does not listen  Quick to lose
 Does not follow interest in boring
instructions activities
Common complaints for impulsivity :
Children with impulsivity seems unable to control their
immediate reactions or to think before they act.
They find it difficult to wait for their turn.
Have difficulty resisting immediate temptation or
delaying gratification.

Common complaints for Hyperactivity :

 Constant motion
 fidget
 Squirm
 Climb
 Run around in the room aimlessly
2. AUTISM SPECTRUM DISORDER (ASD):

 It is characterised by :
• Widespread impairments in social
interaction communication skills,
• Stereotyped patterns of behaviours,
• Restricted range of interests, and
• Strong desire for routine.

 About 70 percent of children with autism

spectrum disorder have intellectual
disabilities
3. INTELLECTUAL DISABILITY:

 Intellectual disability refers to below

average intellectual functioning with an
IQ of approximately 70 or below.

4. SPECIFIC LEARNING DISORDER:

These get manifested during early school
years and the individual encounters
problems in basic skills in reading, writing
and/or mathematics.
DISRUPTIVE, IMPULSE-CONTROL AND
CONDUCT DISORDERS

1. Oppositional Defiant Disorder

(ODD):
 Display Inappropriate amount of
stubbornness
 Irritable
 Defiant
 Disobedient
 Behave in a hostile manner
2. CONDUCT DISORDER AND ANTISOCIAL BEHAVIOUR:

Age inappropriate actions and attitudes that

violate family expectations, societal norms,
and personal or property right of others.

• The behaviors includes:

 aggressive action that cause harm to others
 Non aggressive conduct that cause property
damage
 Major deceitfulness or theft
 Serious rule violation
Children may show different type of
aggressive behaviour in conduct disorder:

 Verbal Aggression: Name – calling,

swearing
 Physical aggression: Hitting , fighting
 Hostile aggression: Directed at inflicting
injury to others
 Proactive aggression: Dominating and
bullying others without provocation.
FEEDING AND EATING DISORDERS
Anorexia nervosa : has distorted body image that leads
her/him to see herself/ himself overweight.
 Often refusing to eat.
 Exercising excessively.
 Lose large amount of weight and even starve
herself/himself to death.

Bulimia Nervosa: Individual may eat excessive amounts

of food, then purge her/his body of food by using
medicines such as laxatives or diuretics or by
vomiting . feels disgusted and ashamed when s/he
binges and is relieves of tension and negative
emotions after purging

Binge eating: frequent episodes of out-control eating.

SUBSTANCE RELATED AND ADDICTIVE
DISORDERS

Disorder related to maladaptive

behaviour resulting from regular and
consistent use of the substance involve
are substance abuse disorder.

Two subgroups:
Substance dependence
Substance abuse
1. Substance Abuse: there is a recurrent and
significant adverse consequences related
to the use of substances.

* Damage their family and social

relationships, perform poorly at work and
create physical hazards

 Tolerance
 Withdrawal
FORMS OF SUBSTANCE ABUSE:

1. Alcohol: Abuse and Dependence

2. Heroin: Abuse and Dependence
3. Cocaine Abuse and Dependence

( note: Affect of alcohol in our

body.
table 4.2 is important)
The end