1. Psychology, Fifth Edition, James S. Nairne
Chapter 14
Chapter 14
Psychological Disorders

2. Psychology, Fifth Edition, James S. Nairne
Chapter 14
What’s It For? Psychological Disorders
• Conceptualizing Abnormality
• Classifying Psychological Disorders
• Understanding Psychological Disorders

3. Psychology, Fifth Edition, James S. Nairne
Chapter 14
Conceptualizing Abnormality: Learning
Goals
1. Evaluate the various criteria that have been
used to define abnormality.
2. Discuss the legal definition of insanity.
3. Explain how the medical model classifies
and categorizes abnormality.
4. Discuss the effects of diagnostic labeling.

4. Psychology, Fifth Edition, James S. Nairne
Chapter 14
Characteristics of Abnormal Behavior
• Behavior must fit at least several of the
following criteria to be labeled abnormal:
– Statistical deviance -- infrequency
– Cultural deviance -- violates norms
– Emotional distress -- unhappiness, torment
– Dysfunction -- difficulties with daily living
• “Abnormal” behavior not a rigid category

5. Psychology, Fifth Edition, James S. Nairne
Chapter 14

6. Psychology, Fifth Edition, James S. Nairne
Chapter 14
The Concept of Insanity
• Insanity: A legal term defined as inability to
understand that certain actions are wrong at
the time of a crime
– Under this definition, people with disorders
may be judged legally sane
• Famous cases in which the insanity defense
succeeded: John Hinckley Jr., Jeffrey
Dahmer
• Used in < 1% of criminal felony cases

7. Psychology, Fifth Edition, James S. Nairne
Chapter 14
Abnormality as a Disease: The Medical
Model
• View that abnormal behavior is symptomatic
of underlying “disease” that can be “cured”
with appropriate therapy
– Draws an analogy between mental and
physical illness
• A widely held view, but some question it
– Causes of mental illness often unclear
– Social, cultural context of symptoms is
important, more so than for physical illness

8. Psychology, Fifth Edition, James S. Nairne
Chapter 14
Problems Associated With Labeling
• Diagnostic labeling effects: Labels for
psychological problems can become self-
fulfilling prophecies
– Make it difficult to recognize normal
behavior when it occurs
– May increase likelihood of abnormal
behavior
• Rosenhan (1973): Participants faked
disorders to enter psychiatric ward
– Other patients saw through the deception,
but staff did not

9. Psychology, Fifth Edition, James S. Nairne
Chapter 14
Classifying Psychological Disorders:
Learning Goals
1. Describe the DSM-IV-TR.
2. Describe the common anxiety disorders.
3. Describe the somatoform disorders.
4. Describe the common dissociative
disorders.
5. Describe the common mood disorders.
6. Describe the characteristics of
schizophrenia.
7. Describe the common personality disorders.

10. Psychology, Fifth Edition, James S. Nairne
Chapter 14
What Is the DSM-IV-TR?
• Diagnostic and Statistical Manual of Mental
Disorders, 4th edition, Text Revision
– Published by the American Psychiatric
Association
• Used for the diagnosis and classification of
psychological disorders
– Intended to give objective, measurable
criteria for diagnosing disorders
– Does not suggest therapies or treatments
– Does not discuss possible causes

11. Psychology, Fifth Edition, James S. Nairne
Chapter 14
The Five Axes of the DSM-IV-TR
• “Axis” = Rating dimension
• Axis I: Major clinical disorders
– Examples: Schizophrenia; substance
abuse
• Axis II: Personality disorders
– Example: Paranoid personality disorder

12. Psychology, Fifth Edition, James S. Nairne
Chapter 14
The Five Axes, continued…
• Axis III: General medical conditions
– Example: Diseases of the circulatory
system
• Axis IV: Psychosocial and environmental
problems
– Example: Homelessness
• Axis V: Global assessment of functioning
scale

13. Psychology, Fifth Edition, James S. Nairne
Chapter 14
Anxiety Disorders
• Marked by excessive apprehension, worry
that impairs normal functioning
• Generalized anxiety disorder: “Free-floating”
anxiety, chronic worrying lasting over 6
months
• Panic disorder: Recurrent discrete episodes
or attacks of extremely intense fear or dread
– Many physical symptoms such as chest
pains
– May be associated with agoraphobia (fear
of public places)

14. Psychology, Fifth Edition, James S. Nairne
Chapter 14
Anxiety Disorders, continued…
• Obsessive-compulsive disorder: Persistent,
uncontrollable thoughts (obsessions) or compelling
need to perform repetitive acts (compulsions)
– Examples: Excessive cleaning, checking
• Phobic disorders: Highly focused, irrational fear of a
specific object or situation (e.g., snakes)
• Social anxiety disorder: Extreme anxiety in everyday
social situations, often accompanied by physical
symptoms

15. Psychology, Fifth Edition, James S. Nairne
Chapter 14

16. Psychology, Fifth Edition, James S. Nairne
Chapter 14
Anxiety Disorders: Gender and Culture
• Women are more likely to suffer from anxiety
disorders than are men
– Explanations focus on socialization
differences between men and women
• Anxiety disorders occur in all cultures, but the
focus of the anxiety can differ

17. Psychology, Fifth Edition, James S. Nairne
Chapter 14
Somatoform Disorders
• Psychological disorders that focus on the
physical body
• Hypochondriasis: Long-lasting preoccupation
with idea that one has a serious disease,
based on misinterpretation of normal body
reactions
• Somatization disorder: Long-lasting
preoccupation with body symptoms that have
no physical cause
• Conversion disorder: Real physical problems
that seem to have no physical cause

18. Psychology, Fifth Edition, James S. Nairne
Chapter 14
Somatoform Disorders: Gender and Culture
• Somatization and conversion disorders occur
somewhat more frequently in women than in
men
• Hypochondriasis occurs equally often in men
and women
• Somatoform disorders occur cross-culturally
but with some culturally specific expressions
– e.g., koro -- Asian men
– e.g., dhat -- men in India

19. Psychology, Fifth Edition, James S. Nairne
Chapter 14
Dissociative Disorders
• Characterized by separation, or dissociation,
of conscious awareness from previous
thoughts or memories
• Dissociative amnesia: Inability to remember
important personal information
– Generally psychological in origin
• Dissociative fugue: Loss of personal identity,
often accompanied by a flight from home

20. Psychology, Fifth Edition, James S. Nairne
Chapter 14
Dissociative Identity Disorder
• Individual alternates between what appear to
be two or more distinct identities or
personalities
– Also known as multiple personality disorder
• Recognized by DSM-IV-TR, but not all
clinicians believe in it
– Some symptoms can be faked; others,
such as optical changes, less easy to fake
– Some clinicians view it as role-playing

21. Psychology, Fifth Edition, James S. Nairne
Chapter 14

22. Psychology, Fifth Edition, James S. Nairne
Chapter 14
Mood Disorders
• Prolonged, disabling disruptions in emotional
state
• Two types:
– Depressive disorders: Individual suffers
mainly from depression
– Bipolar disorders: Mood swings between
depression and extreme highs called
manic states

23. Psychology, Fifth Edition, James S. Nairne
Chapter 14
Major Depressive Episode
• Five or more of these symptoms for at least 2
weeks:
– Depressed mood for most of the day
– Loss of interest in normal daily activities
– Significant weight change
– Change in activity level
– Daily fatigue or loss of energy
– Negative self-concept
– Trouble concentrating or making decisions
– Suicidal thoughts

24. Psychology, Fifth Edition, James S. Nairne
Chapter 14
Suicide
• One possible consequence of mood
disorders, including bipolar disorder
– Third leading cause of death among
adolescents, eighth leading among all ages
– Risk factors besides mood disorders
include alcohol use, stressful events
• Another major predictor: Prior suicide
attempts and thoughts
– Suicidal thoughts are a serious warning
sign

25. Psychology, Fifth Edition, James S. Nairne
Chapter 14
Bipolar Disorder: Mania
• Manic state: Person becomes hyperactive,
talkative, decreased need for sleep
• Manic state must last at least a week to be
classified as such, but may last for months
• Note that functioning is often severely
impaired

26. Psychology, Fifth Edition, James S. Nairne
Chapter 14
Mood Disorders: Gender and Culture
• Around the world, women more likely than
men to suffer from major depression
• Women more likely than men to attempt
suicide; men more likely to succeed
• No gender difference for bipolar disorder
• Symptoms of depression are similar across
cultures, though content of depressive
thoughts varies somewhat

27. Psychology, Fifth Edition, James S. Nairne
Chapter 14
Schizophrenia
• Involves fundamental disturbances in thought
processes, emotion, and/or behavior
• Complex disorder that may be expressed in a
variety of ways
– Diagnosis comes from a variety of
symptoms

28. Psychology, Fifth Edition, James S. Nairne
Chapter 14
Schizophrenia
• Positive symptoms: Observable expressions
of abnormal behavior
– Hallucinations
– Delusions
– Disorganized speech
• Negative symptoms: Elimination or reduction
of normal behavior
– Flat affect: Little or no emotional reaction to
events
– Refusing to take care of self

29. Psychology, Fifth Edition, James S. Nairne
Chapter 14
Schizophrenia: Gender and Culture
• Men at slightly greater risk than women for
schizophrenia
• Men tend to develop schizophrenia earlier in
life than do women
• Schizophrenia occurs worldwide, but there
are some racial differences in diagnosis rates
in the U.S.

30. Psychology, Fifth Edition, James S. Nairne
Chapter 14
Personality Disorders
• Chronic, enduring patterns of behavior
leading to significant impairment in social
functioning
– Tendency to act inflexibly
• Examples:
– Paranoid personality disorder
– Dependent personality disorder
– Antisocial personality disorder
• Some clinicians view these as extremes of
personality rather than disorders per se

31. Psychology, Fifth Edition, James S. Nairne
Chapter 14
Understanding Psychological Disorders:
Learning Goals
1. Explain how biological and genetic factors
can contribute to psychological disorders.
2. Discuss how maladaptive thoughts can
contribute to psychological disorders.
3. Explain how environmental factors can
contribute to psychological disorders.

32. Psychology, Fifth Edition, James S. Nairne
Chapter 14
Biological Factors
• Include physical problems with the body,
brain, as well as genetic influences
• Neurotransmitter imbalances:
– Dopamine excess in schizophrenia
– Serotonin involved in mood disorders, but
exactly how is less clear
• Structural problems in the brain:
– Schizophrenia associated with enlarged
ventricles

33. Psychology, Fifth Edition, James S. Nairne
Chapter 14
Genetic Contributions
• Do some people inherit predispositions
toward developing disorders?
• Genetic component of schizophrenia:
– Likelihood of having it increases with
closeness of a relative who also has it
– Highest likelihood for identical twin
(chances are 1 in 2)
• Similar pattern for depression, bipolar
disorder

34. Psychology, Fifth Edition, James S. Nairne
Chapter 14

35. Psychology, Fifth Edition, James S. Nairne
Chapter 14
Cognitive Factors
• Maladaptive thought patterns may contribute
• Maladaptive attributions
– Internal, stable, global attributions for
negative experiences may play a role in
depression
• Learned helplessness: Acquired when people
repeatedly fail in attempts to control
environment
– May also contribute to depression

36. Psychology, Fifth Edition, James S. Nairne
Chapter 14

37. Psychology, Fifth Edition, James S. Nairne
Chapter 14
Environmental Factors
• Do people learn to act abnormally?
• Role of culture
– A culture that emphasizes thinness may
predispose you to anorexia nervosa
– Cultural background may influence the
kinds of delusions seen in schizophrenia
• Conditioning may play a role as well
– Specific phobias may be acquired through
classical conditioning or observational
learning