7 - Psychological Disorders

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Discuss the characteristics and causes of attention-deficit hyperactivity disorder (ADHD).

A considerably more common childhood disorder is attention-deficit hyperactivity disorder, or ADHD, a disorder marked by inattention, impulsiveness, a low tolerance for frustration, and generally a great deal of inappropriate activity. Although all children show such behavior some of the time, it is so common in children diagnosed with ADHD that it interferes with their everyday functioning. The cause of ADHD is not known, although most experts feel that it is produced by dysfunctions in the nervous system. For example, one theory suggests that unusually low levels of arousal in the central nervous system cause ADHD. To compensate, children with ADHD seek out stimulation to increase arousal. Still, such theories are speculative. Furthermore, because many children occasionally show behaviors characteristic of ADHD, it often is misdiagnosed or in some cases overdiagnosed. Only the frequency and persistence of the symptoms of ADHD allow for a correct diagnosis, which only a trained professional can do.

Discuss the causes of anxiety disorders and obsessive-compulsive disorder (OCD).

A number of factors play a role in the development of anxiety disorders and obsessive-compulsive disorder (OCD). Genetic factors clearly are part of the picture. For example, if one member of a pair of identical twins has panic disorder, there is a 30% chance that the other twin will have it also. Furthermore, a person's characteristic level of anxiety is related to a specific gene involved in the production of the neurotransmitter serotonin. This is consistent with findings indicating that certain chemical deficiencies in the brain appear to produce some kinds of anxiety disorder. Some researchers believe that an overactive autonomic nervous system may be at the root of panic attacks. Specifically, they suggest that poor regulation of the brain's locus ceruleus may lead to panic attacks, which cause the limbic system to become overstimulated. In turn, the overstimulated limbic system produces chronic anxiety, which ultimately leads the locus ceruleus to generate still more panic attacks. There are also biological causes involved in OCD. For example, researchers have found specific differences in the brains of those with the disorder compared to those without it. Psychologists who employ the behavioral perspective emphasize environmental factors when explaining anxiety disorders. They consider anxiety to be a learned response to stress. For instance, suppose a dog bites a young girl. When the girl next sees a dog, she is frightened and runs away—a behavior that relieves her anxiety and thereby reinforces her avoidance behavior. After repeated encounters with dogs in which she is reinforced for her avoidance behavior, she may develop a full-fledged phobia regarding dogs. Finally, the cognitive perspective suggests that anxiety disorders grow out of inappropriate and inaccurate thoughts and beliefs about circumstances in a person's world. For example, people with anxiety disorders may view a friendly puppy as a ferocious and savage pit bull, or they may see an air disaster looming every moment they are in the vicinity of an airplane. According to the cognitive perspective, people's maladaptive thoughts about the world are at the root of an anxiety disorder.

Describe personality disorder. Review the nature and potential bases of both antisocial personality disorder and borderline personality disorder.

A personality disorder is characterized by a set of inflexible, maladaptive behavior patterns that keep a person from functioning appropriately in society.People with personality disorders have little sense of personal distress. Moreover, people with personality disorders frequently lead seemingly normal lives. However, just below the surface lies a set of inflexible, maladaptive personality traits that prevent them from functioning effectively as members of society. The best-known type of personality disorder is the antisocial personality disorder (sometimes referred to as a sociopathic personality). Individuals with this disturbance show no regard for the moral and ethical rules of society or the rights of others. Although they can appear quite intelligent and likable (at least at first), upon closer examination they turn out to be manipulative and deceptive. Moreover, they lack any guilt or anxiety about their wrongdoing. When those with antisocial personality disorder behave in a way that injures someone else, they understand intellectually that they have caused harm but feel no remorse. People with antisocial personality disorder are often impulsive and lack the ability to withstand frustration. They can be extremely manipulative. They also may have excellent social skills; they can be charming, engaging, and highly persuasive. Some of the best con artists have antisocial personalities. People with borderline personality disorder have problems regulating emotions and thoughts, display impulsive and reckless behavior, and have unstable relationships with others. They also have difficulty in developing a clear understanding of who they are. As a consequence, they tend to rely on relationships with others to define their identity. The problem with this strategy is that even minor rejection by others is devastating to those with borderline personality disorder. Furthermore, they generally distrust others and have difficulty controlling their anger. Their emotional volatility leads to impulsive and self- destructive behavior. Individuals with borderline personality disorder often feel empty and alone, and they have difficulty cooperating with others. They may form intense, sudden, one-sided relationships in which they demand the attention of another person and then feel angry when they do not receive it. One reason for this behavior is that they may have a background in which others discounted or criticized their emotional reactions, and they may not have learned to regulate their emotions effectively.

Discuss major depressive disorder or major depression in the case of children and adolescents.

Childhood is typically viewed as a time of innocence and relative freedom from stress. In reality, though, almost 20% of children and 40% of adolescents experience significant emotional or behavioral disorders. Although major depression is more prevalent in adults, around 2.5% of children and more than 8% of adolescents suffer from the disorder. In fact, by the time they reach age 20, between 15 and 20% of children and adolescents will experience an episode of major depression. Children do not always display depression the same way adults do. Rather than showing the expression of profound sadness or hopelessness, childhood depression may produce the expression of exaggerated fears, clinginess, or avoidance of everyday activities. In older children, the symptoms may be sulking, school problems, and even acts of delinquency.

Discuss the characteristics of conversion disorders.

Conversion disorders are a type of somatic symptom disorder. Conversion disorders involve an apparent physical disturbance, such as the inability to see or hear or to move an arm or leg. However, the cause of the physical disturbance is purely psychological; there is no biological reason for the problem. Conversion disorders often begin suddenly. Previously normal people wake up one day blind or deaf, or they experience numbness that is restricted to a certain part of the body. A hand, for example, may become entirely numb, while an area above the wrist, controlled by the same nerves, remains sensitive to touch—something that is physiologically implausible. Mental health professionals refer to such a condition as "glove anesthesia" because the numb area is the part of the hand covered by a glove and not a region related to pathways of the nervous system. Surprisingly, people who experience conversion disorders frequently remain unconcerned about symptoms that most of us would expect to be highly anxiety producing.

Discuss how culture affects the prevalence and presentation of psychological disorders.

Culture dramatically influences the types of psychological abnormality one observes as well as the way psychological abnormality is expressed. Among all the major adult disorders included in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, categorization a minority are found across all cultures of the world. Most others are prevalent primarily in North America and Western Europe. 38 For instance, take anorexia nervosa, the disorder in which people become obsessed with their weight and sometimes stop eating, ultimately starving to death in the process. This disorder occurs most frequently in cultures that hold the societal standard that slender female bodies are the most desirable. In most of the world, where such a standard does not exist, anorexia nervosa is rare. Furthermore, the disorder may appear in specific ways in a particular culture. For instance, in Hong Kong, symptoms of one form of anorexia relate to complaints of bloated stomachs, rather than fears of becoming fat. Similarly, dissociative identity (multiple personality) disorder makes sense as a problem only in societies in which a sense of self is fairly concrete. In India, the self is based more on external factors that are relatively independent of the person. There, when an individual displays symptom of what people in a Western society would call dissociative identity disorder, Indians assume that that person is possessed either by demons (which they view as a malady) or by gods (which does not require treatment).

Describe dissociative identity disorder and dissociative amnesia.

Dissociative disorders are characterized by the separation (or dissociation) of different facets of a person's personality that are normally integrated and work together. By dissociating key parts of who they are, people are able to keep disturbing memories or perceptions from reaching conscious awareness and thereby reduce their anxiety. Several dissociative disorders exist, although all of them are rare. A person with a dissociative identity disorder (DID) (once called multiple personality disorder) displays characteristics of two or more distinct personalities, identities, or personality fragments. Individual personalities often have a unique set of likes and dislikes and their own reactions to situations. Some people with multiple personalities even carry several pairs of glasses because their vision changes with each personality. Moreover, each individual personality can be well adjusted when considered on its own. The diagnosis of dissociative identity disorder is controversial. It was rarely diagnosed before 1980, when it was added as a category in the third edition of DSM for the first time. At that point, the number of cases increased significantly. Some clinicians suggest the increase was due to more precise identification of the disorder. On the other hand, critics suggest that widespread publicity about cases of DID may have influenced patients to report symptoms of more common personality disorders in ways that made it more likely they would receive a diagnosis of DID. Dissociative amnesia is another dissociative disorder in which a significant, selective memory loss occurs. Dissociative amnesia is unlike simple amnesia, which involves an actual loss of information from memory and typically results from a physiological cause. In contrast, in cases of dissociative amnesia, the "forgotten" material is still present in memory—it simply cannot be recalled. The term repressed memories is sometimes used to describe the lost memories of people with dissociative amnesia. In the most severe form of dissociative amnesia, individuals cannot recall their names, are unable to recognize parents and other relatives, and do not know their addresses. In other respects, though, they may appear quite normal. Apart from an inability to remember certain facts about themselves, they may be able to recall skills and abilities that they developed earlier.

Discuss dissociative fugue.

Dissociative fugue is a form of amnesia in which a person leaves home suddenly and assumes a new identity. In this unusual and rare state, people take sudden, impulsive trips and adopt a new identity. After a period of time—days, months, or sometimes even years— they suddenly realize that they are in a strange place and completely forget the time they have spent wandering. Their last memories are those from the time just before they entered the fugue state.

Discuss the advantages and disadvantages of the three criteria that consider abnormality as a deviation from what is average behavior, as a deviation from an ideal, and as a sense of personal discomfort.

Due to the difficulty in distinguishing normal from abnormal behavior, psychologists have struggled to devise a precise, scientific definition of "abnormal behavior." For instance, consider the following definitions, each of which has advantages and disadvantages:One way of viewing abnormality is as deviation from what is considered to be average behavior. To employ this statistically based approach, we simply observe what behaviors are rare or occur infrequently in a specific society or culture and label those deviations from the norm "abnormal." The difficulty with this definition is that some statistically rare behaviors clearly do not lend themselves to classification as abnormal. Similarly, such a concept of abnormality would unreasonably label a person who has an unusually high IQ as abnormal simply because a high IQ is statistically rare. In short, a definition of abnormality that rests on deviation from the average is insufficient. Another way of viewing abnormality is as deviation from an ideal. An alternative approach considers abnormality in relation to the standard toward which most people are striving. This sort of definition considers behavior abnormal if it deviates enough from some kind of ideal or cultural standard. However, society has few standards on which people universally agree. Furthermore, standards that do arise change over time and vary across cultures. Thus, the deviation from-the-ideal approach is also inadequate. A third way of viewing abnormality is as a sense of personal discomfort. A more useful definition concentrates on the psychological consequences of the behavior for the individual. In this approach, behavior is considered abnormal if it produces a sense of personal distress, anxiety, or guilt in an individual—or if it is harmful to others in some way. Even a definition that relies on personal discomfort has drawbacks, though, because in some especially severe forms of mental disturbance, people report feeling wonderful even though their behavior seems bizarre to others. In such cases, a personal state of well-being exists, yet most people would consider the behavior abnormal.

List the different types of eating disorders and sexual disorders.

Eating disorders include such disorders as anorexia nervosa, bulimia, and binge- eating disorder, characterized by binge eating without behaviors designed to prevent weight gain.Sexual disorders, in which an individual's sexual activity is unsatisfactory, are another important class of problems. They include sexual desire disorders, sexual arousal disorders, and paraphilic disorders, atypical sexual activities that may include nonhuman objects or nonconsenting partners.

Discuss the social and cultural context of psychological disorders.

In considering the nature of the psychological disorders described in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), it is important to keep in mind that the disorders that were included in the manual are a reflection of Western culture at the start of the 21st century. The classification system provides a snapshot of how its authors viewed mental disorder when it was published. In fact, the development of the most recent version of the DSM was a source of great debate, which in part reflects issues that divide society. One specific, newly classified disorder that was added to DSM-5 and that has caused controversy is known as disruptive mood dysregulation disorder. This particular diagnosis is characterized by temperamental outbursts grossly out of proportion to the situation, both verbally and physically, in children between the ages of 6 and 18. Some practitioners argue these symptoms simply define a child having a temper tantrum rather than a disorder. Similarly, someone who overeats 12 times in three months can be considered to be suffering from the new classification of binge-eating disorder, which seems to some critics to be overly inclusive. Finally, hoarding behavior is now placed in its own category of psychological disorder. Some critics suggest this change is more a reflection of the rise of reality shows focusing on hoarding rather than reflecting a distinct category of psychological disturbance. Such controversies underline the fact that our understanding of abnormal behavior reflects the society and culture in which we live. Future revisions of DSM may include a different catalog of disorders. Even now, other cultures might include a list of disorders that are very different from the list that appears in the current DSM.

Describe obsessive-compulsive disorder (OCD).

In obsessive-compulsive disorder (OCD), people are plagued by unwanted thoughts, called obsessions, or feel that they must carry out behaviors, termed compulsions, that they feel driven to perform.An obsession is a persistent, unwanted thought or idea that keeps recurring. For example, a man may go on vacation and wonder the whole time whether he locked his house, or a woman may hear the same tune running through her head over and over. In each case, the thought or idea is unwanted and difficult to put out of mind. Of course, many people suffer from mild obsessions from time to time, but usually such thoughts persist only for a short period. For people with serious obsessions, however, the thoughts persist for days or months and may consist of bizarre, troubling images. As part of an OCD, people may also experience compulsions. Compulsions are irresistible urges to repeatedly carry out some behavior that seems strange and unreasonable even to them. Whatever the compulsive behavior is, people experience extreme anxiety if they cannot do it, even if it is something they want to stop. The acts may be relatively trivial, such as repeatedly checking the stove to make sure all the burners are turned off, or more unusual, such as washing one's hands so much that they bleed. Although carrying out compulsive rituals may lead to some immediate reduction of anxiety, in the long run the anxiety returns. In fact, people with severe cases lead lives filled with unrelenting tension.

Describe panic disorder and generalized anxiety disorder.

In panic disorder, panic attacks occur that last from a few seconds to several hours. Unlike phobias, which are stimulated by specific objects or situations, panic disorders do not have any identifiable stimuli. Instead, during an attack, anxiety suddenly—and often without warning—rises to a peak, and an individual feels a sense of impending, unavoidable doom. Although the physical symptoms differ from person to person, they may include heart palpitations, shortness of breath, unusual amounts of sweating, faintness and dizziness, gastric sensations, and sometimes a sense of imminent death. After such an attack, it is no wonder that people tend to feel exhausted. Panic attacks seemingly come out of nowhere and are unconnected to any specific stimulus. Because they do not know what triggers their feelings of panic, victims of panic attacks may become fearful of going places. In fact, some people with panic disorder develop a complication called agoraphobia, the fear of being in a situation in which escape is difficult and in which help for a possible panic attack would not be available. In extreme cases, people with agoraphobia never leave their homes. In addition to the physical symptoms, panic disorder affects how the brain processes information. For instance, people with panic disorder have reduced reactions in the anterior cingulate cortex to stimuli (such as viewing a fearful face) that normally produce a strong reaction in those without the disorder. It may be that recurring high levels of emotional arousal that patients with panic disorder experience desensitizes them to emotional stimuli. People with generalized anxiety disorder experience long-term, persistent anxiety and uncontrollable worry. Sometimes their concerns are about identifiable issues involving family, money, work, or health. In other cases, though, people with the disorder feel that something dreadful is about to happen but can't identify the reason and thus experience "free-floating" anxiety. Because of persistent anxiety, people with generalized anxiety disorder cannot concentrate or set their worry and fears aside; their lives become centered on their worry. Furthermore, their anxiety is often accompanied by physiological symptoms such as muscle tension, headaches, dizziness, heart palpitations, or insomnia.

Describe major depressive disorder.

Major depressive disorder is a severe form of depression that interferes with concentration, decision making, and sociability. Major depression is one of the more common forms of mood disorders. Some 15 million people in the United States suffer from major depression, and at any one time, 6-10% of the U.S. population is clinically depressed. Almost one in five people in the United States experiences major depression at some point in life, and 15% of college students have received a diagnosis of depression. The cost of depression is more than $34 billion a year in lost productivity. Women are twice as likely to experience major depression as men are, with one-fourth of all females apt to encounter it at some point during their lives. Furthermore, although no one is sure why, the rate of depression is going up throughout the world. Results of in-depth interviews conducted in the United States, Puerto Rico, Taiwan, Lebanon, Canada, Italy, Germany, and France indicate that the incidence of depression has increased significantly over previous rates in every area. In fact, in some countries, the likelihood that individuals will have major depression at some point in their lives is three times higher than it was for earlier generations. In addition, people are developing major depression at increasingly younger ages. When psychologists speak of major depressive disorder, they do not mean the sadness that accompanies one of life's disappointments, which we all have experienced. Some depression is normal after the breakup of a long-term relationship, the death of a loved one, or the loss of a job. It is normal even after less serious problems, such as doing badly on a test or having a romantic partner forget one's birthday. People who suffer from major depressive disorder experience similar feelings, but the severity tends to be considerably greater. They may feel useless, worthless, and lonely, and they may think the future is hopeless and no one can help them. They may lose their appetite and have no energy. Moreover, they may experience such feelings for months or even years. They may cry uncontrollably, have sleep disturbances, and be at risk for suicide. The depth and duration of such behavior are the hallmarks of major depressive disorder.

Describe psychoactive substance use disorder and alcohol use disorders.

Psychoactive substance use disorder relates to problems that arise from the use and abuse of drugs. Alcohol use disorders are among the most serious and widespread problems. Both psychoactive substance use disorder and alcohol use disorder co-occur with many other psychological disorders, such as mood disorders, trauma- and stressor-related disorders, and schizophrenia, which complicate treatment considerably.

How do psychologists typically define abnormal behavior? Discuss the aspects of the criteria that consider abnormality as the inability to function effectively and as a legal concept.

Psychologists typically use a broad definition of abnormal behavior. Specifically, abnormal behavior is generally defined as behavior that causes people to experience distress and hinders them from functioning in their daily lives.Psychologists have outlined five criteria that help to define abnormality: abnormality as a deviation from what is average behavior, abnormality as a deviation from an ideal, abnormality as a sense of personal discomfort, abnormality as the inability to function effectively, and abnormality as a legal concept. Each of these approaches, however, have their respective advantages and disadvantages. One way of viewing abnormality is as the inability to function effectively. Most people are able to feed themselves, hold a job, get along with others, and in general live as productive members of society. Yet there are those who are unable to adjust to the demands of society or function effectively. According to this view of abnormality, people who are unable to function effectively and to adapt to the demands of society are considered abnormal. For example, an unemployed, homeless woman living on the street may be considered unable to function effectively. Therefore, her behavior can be viewed as abnormal even if she has chosen to live this way. Her inability to adapt to the requirements of society is what makes her "abnormal," according to this approach.Another way of viewing abnormality is as a legal concept. To the judicial system, the distinction between normal and abnormal behavior rests on the definition of insanity, which is a legal but not a psychological term. In fact, the definition of insanity varies from one jurisdiction to another. In some states, insanity simply means that defendants cannot understand the difference between right and wrong at the time they commit a criminal act. Other states consider whether defendants are substantially incapable of understanding the criminality of their behavior or unable to control themselves. In some jurisdictions, pleas of insanity are not allowed at all.

Briefly outline the humanistic perspective and the sociocultural perspective on psychological disorders.

Psychologists who subscribe to the humanistic perspective emphasize the responsibility people have for their own behavior even when their behavior is considered abnormal. The humanistic perspective—growing out of the work of Carl Rogers and Abraham Maslow—concentrates on what is uniquely human—that is, it views people as basically rational, oriented toward a social world, and motivated to seek self-actualization. Humanistic approaches focus on the relationship of the individual to society; it considers the ways in which people view themselves in relation to others and see their place in the world. The humanistic perspective views people as having an awareness of life and of themselves that leads them to search for meaning and self-worth. Rather than assuming that individuals require a "cure," the humanistic perspective suggests that they can, by and large, set their own limits of what is acceptable behavior. As long as they are not hurting others and do not feel personal distress, people should be free to choose the behaviors in which they engage. Although the humanistic perspective has been criticized for its reliance on unscientific, unverifiable information and its vague, almost philosophical formulations, it offers a distinctive view of abnormal behavior. It stresses the unique aspects of being human and provides a number of important suggestions for helping those with psychological problems. The sociocultural perspective assumes that people's behavior—both normal and abnormal—is shaped by the society and culture in which they live. According to this view, societal and cultural factors such as poverty and prejudice may be at the root of abnormal behavior. Specifically, the kinds of stresses and conflicts people experience in their daily lives can promote and maintain abnormal behavior.This perspective is supported by research showing that some kinds of abnormal behavior are far more prevalent among certain social classes than they are in others. For instance, diagnoses of schizophrenia tend to be higher among members of lower socioeconomic groups than among members of more affluent groups. Proportionally more African-American individuals are hospitalized involuntarily for psychological disorders than are whites. Furthermore, poor economic times seem to be linked to general declines in psychological functioning, and social problems such as homelessness are associated with psychological disorders. On the other hand, alternative explanations abound for the association between abnormal behavior and social factors. For example, people from lower socioeconomic levels may be less likely than those from higher levels to seek help, gradually reaching a point where their symptoms become severe and warrant a serious diagnosis. Furthermore, sociocultural explanations provide relatively little specific guidance for the treatment of individuals showing mental disturbance because the focus is on broader societal factors.

Describe schizophrenia. What are the characteristics that reliably distinguish schizophrenia from other disorders?

Schizophrenia refers to a class of disorders in which severe distortion of reality occurs. Thinking, perception, and emotion may deteriorate; the individual may withdraw from social interaction; and the person may display bizarre behavior. The symptoms displayed by persons with schizophrenia may vary considerably over time. Nonetheless, a number of characteristics reliably distinguish schizophrenia from other disorders. They include the following: (a) Decline from a previous level of functioning: An individual can no longer carry out activities he or she was once able to do.(b) Disturbances of thought and speech: People with schizophrenia use logic and language in a peculiar way. Their thinking often does not make sense, and their logic is frequently faulty, which is referred to as a formal thought disorder. They also do not follow conventional linguistic rules. (c) Delusions: People with schizophrenia often have delusions—firmly held, unshakable beliefs with no basis in reality. Among the common delusions people with schizophrenia experience are the beliefs that they are being controlled by someone else, they are being persecuted by others, and their thoughts are being broadcast so that others know what they are thinking. (d) Hallucinations and perceptual problems: People with schizophrenia sometimes do not perceive the world as most other people do. For example, they may have hallucinations, the experience of perceiving things that do not actually exist. Furthermore, they may see, hear, or smell things differently from others. In fact, they may not even have a sense of their bodies in the way that others do, having difficulty determining where their bodies stop and the rest of the world begins.(e) Inappropriate emotions: People with schizophrenia sometimes show a lack of emotion in which even the most dramatic events produce little or no emotional response. Alternately, they may display strong bursts of emotion that are inappropriate to a situation. For example, a person with schizophrenia may laugh uproariously at a funeral or react with anger when being helped by someone. (f) Withdrawal: People with schizophrenia tend to have little interest in others. They tend not to socialize or hold real conversations with others, although they may talk at another person. In the most extreme cases, they do not even acknowledge the presence of other people and appear to be in their own isolated worlds.

Briefly describe the causes of mood disorders.

Several approaches have been used to explain mood disorders.(a) Some mood disorders clearly have genetic and biological roots. In fact, most evidence suggests that bipolar disorders are caused primarily by biological factors. For instance, bipolar disorder (and some forms of major depression) clearly runs in some families, pointing to a genetic cause.Furthermore, researchers have found that several neurotransmitters play a role in depression. For example, alterations in the functioning of serotonin and norepinephrine in the brain are related to the disorder. In addition, research on neuroimaging suggests that a brain structure called area 25 is related to depression. When area 25 is smaller than normal, it is associated with a higher risk of depression. Furthermore, the right anterior insula, a region of the brain related to self-awareness and interpersonal experience, also appears to be related to depression.(b) Supporters of psychoanalytic perspectives see depression as the result of feelings of loss (real or potential) or of anger directed inwardly at oneself. However, there is little research evidence to support this explanation. (c) Some explanations of depression take a behavioral approach, looking to influences outside the person. For example, behavioral theories of depression argue that the stresses of life produce a reduction in positive reinforcers. As a result, people begin to withdraw, which only reduces positive reinforcers further. In addition, people receive attention for their depressive behavior, which further reinforces the depression. (d) Some explanations for mood disorders attribute them to cognitive factors. For example, psychologist Martin Seligman suggests that depression is largely a response to learned helplessness. Learned helplessness is a learned expectation that events in one's life are uncontrollable and that one cannot escape from the situation. As a consequence, people simply give up fighting aversive events and submit to them, which thereby produces depression. Other theorists go a step further and suggest that depression results from hopelessness, a combination of learned helplessness and an expectation that negative outcomes in one's life are inevitable. Clinical psychologist Aaron Beck has proposed that faulty cognitions underlie people's depressed feelings. Specifically, his cognitive theory of depression suggests that depressed individuals typically view themselves as life's losers and blame themselves whenever anything goes wrong. By focusing on the negative side of situations, they feel inept and unable to act constructively to change their environment. In sum, their negative cognitions lead to feelings of depression. Brain imaging studies suggest that people with depression experience a general blunting of emotional reactions. For example, one study found that the brains of people with depression showed significantly less activation when they viewed photos of human faces displaying strong emotions than did those without the disorder.

Define somatic symptom disorders. Describe a type of somatic symptom disorder.

Somatic symptom disorders are psychological difficulties that take on a physical (somatic) form but for which there is no medical cause. Even though an individual with somatic symptom disorder reports physical symptoms, no biological cause exists, or if there is a medical problem, the person's reaction is greatly exaggerated. One type of somatic symptom disorder is illness anxiety disorder in which people have a constant fear of illness and a preoccupation with their health. These individuals believe that everyday aches and pains are symptoms of a dread disease. The "symptoms" are not faked; rather, they are misinterpreted as evidence of some serious illness—often in the face of inarguable medical evidence to the contrary.

List and describe a few types of phobic disorders. Provide examples for each type.

Some of the phobic disorders are as follows: (a) Agoraphobia is defined as the fear of places, such as unfamiliar or crowded spaces, where help might not be available in case of emergency. For instance, a person becomes housebound because any place other than the person's home arouses extreme anxiety symptoms. (b) Specific phobias include fear of specific objects, places, or situations. Some people, for instance, have an extreme fear of dogs, cats, or spiders. Such a phobia would be termed as a specific phobia of the animal type. Another specific phobia is the natural environment type, in which a person has a fear of events or situations in the natural environment. A person's fear of storms, heights, or water may be termed as a specific phobia of the natural environment type. A third type of specific phobia is the blood injection injury type, which includes a fear of blood, injury, and injections. A person who panics on seeing a child's scraped knee is likely to have this specific phobia. (c) Social phobia is defined as the fear of being judged or embarrassed by others. A person with a social phobia will avoid all social situations and becomes a recluse for fear of encountering others' judgment.

Describe narcissistic personality disorder.

The narcissistic personality disorder is a type of personality disorder. It is characterized by an exaggerated sense of self-importance. Those with the disorder expect special treatment from others while also disregarding others' feelings, showing little or no sense of empathy for them.

Discuss the predisposition model of schizophrenia.

The predisposition model of schizophrenia suggests that individuals may inherit a predisposition or an inborn sensitivity to develop schizophrenia. This genetic predisposition makes them particularly vulnerable to stressors in their lives, such as social rejection, dysfunctional family communication patterns, or severe economic stress. The stressors in people's lives may vary, but if they are strong enough and are coupled with a genetic predisposition, they result in the appearance of schizophrenia. Furthermore, a strong genetic predisposition may lead to the onset of schizophrenia even when the environmental stressors are relatively weak. On the other hand, someone with a genetic predisposition to develop schizophrenia may avoid developing the disorder if that person experiences relatively few life stressors. In short, schizophrenia is related to several kinds of biological and situational factors. It is increasingly clear, then, that no single factor but rather a combination of interrelated variables produces schizophrenia.

Where does abnormality originate? Respond by making explicit reference to the six major perspectives on abnormality.

Today, six major perspectives are used to understand psychological disorders. These perspectives suggest not only different causes of abnormal behavior but different treatment approaches as well. Furthermore, some perspectives are more applicable to specific disorders than are others. (a) Medical perspective: The medical perspective suggests that when an individual displays symptom of abnormal behavior, the fundamental cause will be found through a physical examination of the individual, which may reveal a hormonal imbalance, a chemical deficiency, or a brain injury. (b) Psychoanalytic perspective: The psychoanalytic perspective holds that abnormal behavior stems from childhood conflicts over opposing wishes regarding sex and aggression. (c) Behavioral perspective: The behavioral perspective views the behavior itself as the problem. Using the basic principles of learning, behavioral theorists see both normal and abnormal behaviors as responses to various stimuli—responses that have been learned through past experience and are guided in the present by stimuli in the individual's environment. To explain why abnormal behavior occurs, we must analyze how an individual has learned it and observe the circumstances in which it is displayed. (d) Cognitive perspective: Rather than considering only external behavior, as in traditional behavioral approaches, the cognitive approach assumes that cognitions (people's thoughts and beliefs) are central to a person's abnormal behavior. A primary goal of treatment using the cognitive perspective is to explicitly teach new, more adaptive ways of thinking. (e) Humanistic perspective: Psychologists who subscribe to the humanistic perspective emphasize the responsibility people have for their own behavior even when their behavior is considered abnormal. The humanistic perspective—growing out of the work of Carl Rogers and Abraham Maslow—concentrates on what is uniquely human—that is, it views people as basically rational, oriented toward a social world, and motivated to seek self- actualization. (f) Sociocultural perspective: The sociocultural perspective assumes that society and culture shape abnormal behavior. According to this view, societal and cultural factors such as poverty and prejudice may be at the root of abnormal behavior. Specifically, the kinds of stresses and conflicts people experience in their daily lives can promote and maintain abnormal behavior.


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