Chapter 14:

1. Human AdjustmentJohn W. Santrock Chapter 14: Psychological Disorders McGraw-Hill © 2006 by The McGraw-Hill Companies, Inc. All rights reserved.

2. Chapter Outline Understanding Abnormal Behavior Anxiety Disorders Dissociative Disorders Mood Disorders Schizophrenia Personality Disorders ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

3. Learning Goals 1. Discuss characteristics and classification of abnormal behavior 2. Distinguish among various anxiety disorders 3. Describe the dissociative disorders 4. Compare the mood disorders and specify risk factors for depression and suicide 5. Identify characteristics and possible causes of schizophrenia 6. Identify behavior patterns typical of personality disorders ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

4. UNDERSTANDING ABNORMAL BEHAVIOR Defining Abnormal Behavior Theoretical Approaches to Psychological Disorders Classifying Abnormal Behavior ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

5. Defining Abnormal Behavior • Deviant - atypical behavior, deviates from acceptable norms • Maladaptive - interferes with person’s ability to function effectively • Personal distress - person does not feel right Abnormal behavior = behavior that is deviant, maladaptive or personally distressful ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

6. Theoretical Approaches to Psychological Disorders • Causes of psychological disorders include biological, psychological, and sociocultural factors and the possibility of a combination of factors ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

7. The Biological Approach • The biological approach attributes psychological disorders to organic, internal causes • Biological factors that contribute to psychological disorders: • abnormalities in brain structure • imbalances in neurotransmitters or hormones • disordered genes ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

8. The Biological Approach • Medical model: • abnormalities are mental illnesses • individuals afflicted are patients • patients are treated by doctors, often with drugs Medical model = describes psychological disorders as medical diseases with a biological origin ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

9. The Psychological Approach • The psychodynamic, behavioral, social cognitive, and humanistic perspectives serve as foundations for understanding psychological factors in psychological disorders ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

10. The Psychological Approach • Psychodynamic perspective - psychological disorders arise from unconscious conflicts that produce anxiety • Behavioral perspective - rewards and punishments in the environment shape abnormal behavior • Social cognitive perspective - environment, observational learning, expectancies, self-efficacy, self-control, and beliefs are key factors in abnormal behavior ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

11. The Sociocultural Approach • Sociocultural approach - emphasis on larger social contexts in which a person lives (individual’s marriage or family, socioeconomic status, ethnicity, gender, culture) • Frequency and intensity of psychological disorders varies across cultures and depends on social, economic, technological, and religious aspects ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

12. An Interactionist Approach: Biopsychosocial • Biopsychosocial approach - abnormal behavior can be influenced by: • biological factors (such as brain processes and heredity) • psychological factors (such as distorted thoughts or low self-esteem) • sociocultural factors (such as ineffective family functioning or poverty) ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

13. Classifying Abnormal Behavior - DSM-IV-TR • American Psychiatric Association first published Diagnostic and Statistical Manual of Mental Disorders in 1952 • DSM-IV-TR (4th edition, text revision) was published in 2000 • DSM-IV-TR has multiaxial system which classifies individuals on the basis of five dimensions, or axes • DSM reflects the medical model ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

14. The Issue of Labeling • DSM classification is controversial: • it labels as disorders what are thought of as everyday problems • it has bias toward finding something wrong • it puts labels on people • Despite disadvantages, DSM-IV-TR is comprehensive and allows clinicians to make predictions ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

15. Review - Learning Goal 1 • What is abnormal behavior? • What factors might be involved in the etiology of psychological disorders? • How does the Diagnostic and Statistical Manual of Mental Disorders classify psychological disorders and what are its advantages and disadvantages? ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

16. ANXIETY DISORDERS Generalized Anxiety Disorder Panic Disorder Phobia Disorders Obsessive-Compulsive Disorder ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

17. Generalized Anxiety Disorder • Anxiety disorders - psychological disorders that include: • motor tension (jumpiness, trembling, inability to relax) • hyperactivity (dizziness, racing heart, perspiration) • apprehensive expectations and thoughts ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

18. Generalized Anxiety Disorder • Generalized anxiety disorder - consists of persistent anxiety over at least one month; the individual with this disorder cannot specify reasons for the anxiety ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

19. Generalized Anxiety Disorder • About 4 million Americans from 18 to 54 years of age have generalized anxiety disorder • Biological factors include genetic predisposition and deficiency of the neurotransmitter GABA • Psychological and sociocultural factors include overly strict and critical parents and negative thoughts when stressed ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

20. Panic Disorder • About 2.4 million Americans have panic disorder Panic disorder = anxiety disorder marked by recurrent sudden onset of intense apprehension or terror ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

21. Panic Disorder • Panic attacks strike without warning and produce: • severe palpitations • shortness of breath • chest pains • trembling • sweating • dizziness • feeling of helplessness ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

22. Agoraphobia Agoraphobia = cluster of fears centered around public places and being unable to escape or to find help should one become incapacitated ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

23. Agoraphobia • People with agoraphobia have fears of: • crowded public places • traveling away from home • feeling confined • being separated from a place or a person ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

24. Panic Disorder • Biological factors in panic disorder include: • overreaction to lactic acid • genetic predisposition • overactive autonomic nervous system • problems with neurotransmitters norepinephrine and GABA ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

25. Panic Disorder • Psychological factors in panic disorder include: • stressful life event • separation from loved one • change in job ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

26. Adjustment Strategies for Coping with Panic 1. Retreat 2. Divert your attention 3. Engage in deep breathing relaxation and positive self-talk ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

27. Phobic Disorders • About 6.3 million Americans have a phobic disorder Phobic disorder = anxiety disorder in which individual has irrational, overwhelming, persistent fear of a particular object or situation ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

28. Phobic Disorders • Common phobias involve: • social situations • dogs • height • dirt • flying • snakes • Social phobia - intense fear of being humiliated or embarrassed in social situations ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

29. Figure 14.3 Phobias ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

30. Figure 14.4 Social Phobias in the United States ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

31. Phobic Disorders • Biological factors: • genetic • neural circuit (thalamus, amygdala, cerebral cortex) • neurotransmitter serotonin • Psychological factors: • defense mechanisms • learned fears ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

32. Obsessive-Compulsive Disorder • About 3.3 million Americans have obsessive-compulsive disorder Obsessive-compulsive disorder (OCD) = anxiety disorder; individual has anxiety-provoking thoughts that will not go away (obsession) and/or urges to perform repetitive, ritualistic behaviors to prevent or produce some future situation (compulsion) ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

33. Obsessive-Compulsive Disorder • Common compulsions include: • checking • cleansing • counting ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

34. Obsessive-Compulsive Disorder • Biological factors • genetic • brain pattern • depletion of neurotransmitter serotonin ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

35. Obsessive-Compulsive Disorder • Psychological factors • life stress • occupation change • marriage change ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

36. Adjustment Strategies for Coping with an Anxiety Disorder 1. Understand that effective treatments are available 2. Ask the therapist what training and experience he or she has in treating anxiety disorders 3. Expect therapist to conduct a thorough diagnostic evaluation 4. Recognize that the length of treatment required can vary 5. Recognize that if one treatment doesn’t work, another one will ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

37. Review - Learning Goal 2 • What are anxiety disorders and what is generalized anxiety disorder? • What are the key features of panic disorder? • Is having a phobic disorder different from a normal fear, and what might cause it? • What is obsessive-compulsive disorder? ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

38. DISSOCIATIVE DISORDERS Dissociative Amnesia and Fugue Dissociative Identity Disorder ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

39. Dissociative Disorders • Under extreme stress, individual’s conscious awareness becomes dissociated (separated) from previous memories Dissociative disorders = psychological disorders that involve sudden loss of memory or change in identity ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

40. Dissociative Amnesia and Fugue • Three types of dissociative disorders: • Dissociative amnesia - extreme memory loss caused by extensive psychological stress • Dissociative fugue - individual not only develops amnesia but also travels away from home and establishes new identity • Dissociative identity disorder (DID) - individuals have two or more distinct personalities ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

41. Review - Learning Goal 3 • What are the characteristics of the dissociative disorders, dissociative amnesia, and fugue? • What is dissociative identity disorder? ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

42. MOOD DISORDERS Depressive Disorders Bipolar Disorder Causes of Mood Disorders Suicide ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

43. Mood Disorders • Two types of mood disorders: • depressive disorders • bipolar disorder Mood disorders = psychological disorders in which there is a disturbance in mood (prolonged emotion that colors the individual’s entire emotional state) ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

44. Depressive Disorders • Major depressive disorder (MDD) - individual experiences a major depressive episode with symptoms lasting at least two weeks • Dysthymic disorder - more chronic and has fewer symptoms then major depressive disorder ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

45. Depressive Disorders • Major depressive episode - individual experiences at least 5 symptoms for at least 2 weeks: • depressed mood most of the day • reduced interest or pleasure in most activities • significant weight change or significant appetite change • trouble sleeping or sleeping too much • psychomotor agitation or retardation • fatigue or loss of energy • feeling worthless or guilty • problems in thinking, concentration, or making decisions • recurrent thoughts of death and suicide ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

46. Adjustment Strategies for Coping with Depression For the Depressed Individual: 1. Recognize that feeling exhausted, worthless, helpless, and hopeless are part of the depression 2. See a therapist ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

47. Adjustment Strategies for Coping with Depression For Family and Friends: 1. Help individual get competent diagnosis and treatment 2. Offer emotional support 3. Invite the depressed person to activities 4. Encourage the depressed individual to participate in activities that he or she once enjoyed 5. Don’t expect him or her to “snap out of it” ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

48. Bipolar Disorder • Most bipolar individuals experience multiple cycles of depression interspersed with manic episodes Bipolar disorder = mood disorder characterized by extreme mood swings that include one or more episodes of mania ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

49. Bipolar Disorder • Manic episode occurs when a person: • feels euphoric • has tremendous energy • is impulsive ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.

50. Biological Causes of Mood Disorders • Biological causes of mood disorders include: • heredity • neurobiological abnormalities • altered brain wave activity during sleep • decrease in brain metabolic activity • neuron death • imbalance of monoamine neurotransmitters (norepinephrine, serotonin, dopamine) • hormones ©2006 by the McGraw-Hill Companies, Inc. All rights reserved.