Chapter 14: Psychological Disorders

A personality disorder, such as antisocial personality, is characterized by

inflexible and enduring behavior patterns that impair social functioning

what are personality disorders?

inflexible and enduring behavior patterns that impair social functioning

Dissociative identity disorder is controversial because

it is almost never reported outside North America

PET scans of murderers' brains have revealed

lower-than-normal activation in the frontal lobes

A therapist says that psychological disorders are sicknesses, and people with these disorders should be treated as patients in a hospital. This therapist's belief reflects the _________ model.

medical

A person with schizophrenia who has (positive/negative) symptoms may have an expressionless face and toneless voice. These symptoms are most common with (chronic/acute) schizophrenia and are not likely to respond to drug therapy. Those with (positive/negative) symptoms are likely to experience delusions and to be diagnosed with (chronic/acute) schizophrenia, which is much more likely to respond to drug therapy.

negative; chronic; positive; acute

Treatment for depression often includes drugs that increase supplies of the neurotransmitters ____and_______ .

norepinephrine; serotonin

Marina became consumed with the need to clean the entire house and refused to participate in any other activities. Her family consulted a therapist, who diagnosed her as having ________ -_______ disorder.

obsessive-compulsive

Chances for recovery from schizophrenia are best when

onset is sudden, in response to stress

Those who experience unpredictable periods of terror and intense dread, accompanied by frightening physical sensations, may be diagnosed with a ____________ disorder.

panic

An episode of intense dread that can be accompanied by chest pains, choking, or other frightening sensations is called

panic attack

Rates of bipolar disorder in the United States rose dramatically in the decade between 1994 and 2003, especially among

people 20 and under

Anxiety that takes the form of an irrational and maladaptive fear of a specific object, activity, or situation is called a ___________ .

phobia

If a person is focusing anxiety on specific feared objects or situations, that person may have a _____________.

phobia

The symptoms________ of appear around age 10; ________ tend[s] to appear later, around age 25.

phobias; major depressive disorder

Those with symptoms of recurring memories and nightmares, hypervigilance, avoidance, social withdrawal, jumpy anxiety, numbness of feeling, and/or insomnia for weeks after a traumatic event may be diagnosed with __________________ disorder.

posttraumatic stress

One predictor of psychiatric disorders that crosses ethnic and gender lines is

poverty

what are anxiety disorders?

psychological disorders characterized by distressing, persistent anxiety or maladaptive behaviors that reduce anxiety

When a person with an anxiety disorder eases anxiety by avoiding or escaping a situation that inspires fear, this is called

reinforcement

Victor exclaimed, "The weather has been so schizophrenic lately: It's hot one day and freezing the next!" In addition to being insensitive to those with schizophrenia, this comparison is inaccurate. Explain.

schizophrenia involves the altered perceptions, emotions, and behaviors of a mind split from reality. It does not involve the rapid changes in mood or identity suggested by this comparison.

what is binge-eating disorder?

significant binge-eating episodes, followed by distress, disgust, or guilt, but without the compensatory purging or fasting that marks bulimia nervosa

Psychologists who emphasize the importance of negative perceptions, beliefs, and thoughts in depression are working within the _________ - _______ perspective.

social-cognitive

What is the medical model?

the concept that diseases, in this case psychological disorders, have physical causes that can be diagnosed, treated, and, in most cases, cured, often through treatment in a hospital.

What is antisocial personality disorder?

A personality disorder in which the person (usually a man) exhibits a lack of conscience for wrongdoing, even toward friends and family members. May be aggressive and ruthless or a clever con artist.

How do major depressive disorder and bipolar disorder differ?

A person with major depressive disorder experiences at least five symptoms of depression (including either depressed mood or loss of interest or pleasure) for two or more weeks. A person with the less common condition of bipolar disorder experiences not only depression but also mania

Which of the following statements is true of bulimia nervosa?

Bulimia is marked by weight fluctuations within or above normal ranges

Why is there controversy over attention-deficit/hyperactivity disorder?

A child who displays extreme inattention and/or hyperactivity and impulsivity may be diagnosed. Controversies center on whether growing number of ADHD cases reflect overdiagnosis or increased awareness of the disorder, and on the long-term effects of stimulant-drug treatment

How should we draw the line between normality and disorder?

According to psychologists and psychiatrists, psychological disorders are marked by a clinically significant disturbance in an individual's cognition, emotion regulation, or behavior. Such dysfunctional or maladaptive thoughts, emotions, or behaviors interfere with daily life, and thus are disordered.

What is panic disorder?

An anxiety disorder marked by unpredictable minutes-long episodes of intense dread in which a person experiences terror and accompanying chest pain, choking, or other frightening sensations; often followed by worry over a possible next attack.

How do generalized anxiety disorder, panic disorder, and phobias differ?

Anxiety disorders are psychological disorders characterized by distressing, persistent anxiety or maladaptive behaviors that reduce anxiety. People with generalized anxiety disorder feel persistently and uncontrollably tense and apprehensive, for no apparent reason. In the more extreme panic disorder, anxiety escalates into periodic episodes of intense dread. Those with a phobia may be irrationally afraid of a specific object, activity, or situation.

What factors contribute to the onset and development of schizophrenia?

Biological factors include abnormalities in brain structure and function and a genetic predisposition to the disorder. Environmental factors such as nutritional deprivation, exposure to virus, and maternal stress contribute to activating the genes that increase risk

Researchers believe that conditioning and cognitive processes are aspects of learning that contribute to anxiety-related disorders. What biological factors also contribute to these disorders?

Biological factors include inherited temperament differences and other gene variations; experience-altered brain pathways; and outdated, inherited responses that had survival value for our distant ancestors

What is the biopsychosocial approach, and why is it important in our understanding of psychological disorders?

Biological, psychological, and social-cultural influences combine to produce psychological disorders. This approach helps us understand that our well-being is affected by our genes, brain functioning, inner thoughts and feelings, and the influences of our social and cultural environment.

Why is the DSM, and the DSM-5 in particular, considered controversial?

Critics have expressed concerns about the negative effects of labelling by the DSM and other classification systems. Labels have the potential to be both subjective and stigmatizing. Further, critics suggest that the DSM-5 casts too wide a net on disorders, pathologizing normal behavior

what are the three main eating disorders, and how do biological, psychological, and social-cultural influences make people more vulnerable to them?

In those with eating disorders, psychological factors overwhelm the body's tendency to maintain a normal weight. Despite being significantly underweight, people with anorexia nervosa continue to diet and sometimes exercise excessively because they view themselves as fat. Those with bulimia nervosa secretly binge and then compensate by purging, fasting, or excessively exercising. Those with binge-eating disorder binge out but do not follow with purging, fasting, and exercising. Cultural pressures, low self-esteem, and negative emotions interact with stressful life experiences and genetics to produce eating disorders.

What does it mean to say that "depression is a whole-body disorder"?

Many factors contribute to depression, including the biological influences of genetics and brain function. Social-cognitive factors also matter, including the interaction of explanatory style, mood, our responses to stressful experiences, changes in our patterns of thinking and behaving, and cultural influences. Depression involves the whole body and may disrupt sleep, energy levels, and concentration.

Do psychological disorders predict violent behavior?

Mental disorders seldom lead to violence, but when they do, they raise moral and ethical questions about whether society should hold people with disorders responsible for their violent actions. Most people with disorders are nonviolent and are more likely to be victims than attackers.

Anna is embarrassed that it takes her several minutes to parallel park her car. She usually gets out of the car once or twice to inspect her distance both from the curb and from the nearby cars. Should she worry about having a psychological disorder?

No. Anna's behavior is unusual, causes her distress, and may make her a few minutes late on occasion, but it does not appear to significantly disrupt her ability to function. Like most of us, Anna demonstrates some unusual behaviors. Since they are not disabling or dysfunctional, they do not suggest a psychological disorder.

Those who express anxiety through unwanted repetitive thoughts or actions may have a(n) _____-________ disorder.

Obsessive-compulsive

What is disruptive mood dysregulation disorder?

Patients who have this disorder exhibit recurrent temper outbursts that are severe and do not correlate with the situation

What brain abnormalities are associated with schizophrenia?

People with schizophrenia have an excess number of dopamine receptors, which may intensify brain signals, creating positive symptoms such as hallucinations and paranoia. Brains scans have revealed abnormal activity in the frontal lobes, thalamus, and amygdala, as well as a loss of neural connections across the brain network. Brain abnormalities associated with schizophrenia include enlarged, fluid-filled areas and corresponding shrinking and thinning of cerebral tissue

what are three clusters of personality disorders? what behaviors and brain activity characterize the antisocial personality?

Personality disorders are inflexible and enduring behavior patterns that impair social functioning. The ten DSM-5 disorders tend to form three clusters, characterized by anxiety, eccentric or odd behaviors, and dramatic or impulsive behaviors. Antisocial personality disorder is characterized by a lack of conscience and, sometimes, by aggressive and fearless behavior. The amygdala is smaller and the frontal lobes less active in people with this disorder, leading to impaired frontal lobe cognitive functions and decreased responsiveness to others' distress. Genetic predispositions may interact with the environment to produce these characteristics.

What prenatal events are associated with increased risk of developing schizophrenia?

Possible contributing factors include maternal diabetes, older paternal age, viral infections or famine conditions during the mother's pregnancy, and low weight or oxygen deprivation at birth

What is the relationship between poverty and psychological disorders?

Poverty-related stresses can help trigger disorders, but disabling disorders can also contribute to poverty. Thus, poverty and disorder are often a chicken-and-egg situation; it's hard to know which came first.

How many people have, or have had, a psychological disorder? What are some of the risk factors?

Psychological disorder rates vary, depending on the time and place of the survey. In one multinational survey, the lowest rate of reported mental disorders was in Nigeria, the highest rate (6 percent), the highest rate in the US (26 percent). Poverty is a risk factor. But some disorders, such as schizophrenia, can also drive people into poverty. Immigration to the US may average better mental health than their US counterparts with the same ethnic heritage (a phenomenon known as the immigrant paradox).

What patterns of perceiving, thinking, and feeling characterize schizophrenia?

Schizophrenia is a psychotic disorder characterized by delusions, hallucinations, disorganized speech, and/or diminished, inappropriate emotional expression. Hallucinations are sensory experiences without sensory stimulation; delusions are false beliefs. Schizophrenia symptoms may be positive (the presence of inappropriate behaviors) or negative (the absence of appropriate behaviors).

How do chronic schizophrenia and acute schizophrenia differ?

Schizophrenia typically strikes during late adolescence, affects males slightly more often, and occurs in all cultures. In chronic schizophrenia, development is gradual and recovery is doubtful. In acute schizophrenia, onset is sudden - in reaction to stress - and prospects for recovery are brighter

What are dissociative disorders, and why are they controversial?

Skeptics note that DID increased dramatically in the late 20th century; is rarely found outside North America; and may reflect role playing by people vulnerable to therapists' suggestions. Other view DID as a manifestation of feelings of anxiety or as a response learned when behaviors are reinforced by anxiety-reduction

Are psychological disorders universal or culture-specific? Explain with examples.

Some psychological disorders are culture-specific: (anorexia nervosa in Western cultures, tajin kyofusho appears largely in Japan); other disorders, like major depressive disorder and schizophrenia, are universal

What factors increase the risk of suicide, and what do we know about nonsuicidal self-injury?

Suicide rates differ by nation, race, gender, age group, income, religious involvement, martial status, and other factors. Those lacking social support, such as many gay, transgender and gender nonconforming youth, are at increased risk, as are people who have been anxious or depressed. Forewarning of suicide may include verbal hints, giving away possessions withdrawal, and preoccupation with death. People who talk about suicide should be taken seriously: listen and empathize, connect them to help, and protect those who appear at immediate risk. Nonsuicidal self-injury (NSSI) does not usually lead to suicide but may escalate to suicidal thought and acts if untreated. People who engage in NSSI do not tolerate stress well and tend to be self-critical, with poor communication and problem-solving skills.

What is susto, and is this a culture-specific or universal psychological disorder?

Susto is a condition marked by severe anxiety, restlessness, and a fear of black magic. It is culture-specific to Latin America

How and why do clinicians classify psychological disorders, and why do some psychologists criticize the use of diagnostic labels?

The American Psychiatric Association's DSM-5 contains diagnostic labels and descriptions that provide a common language and shared concepts for communication and research. Critics of the DSM say it casts too wide a net, pathologizing normal behaviors. A complementary approach to classification is the U.S National Institute of Mental Health's Research Domain Criteria project, a framework that organizes disorders according to behaviors and brain activity along several dimensions. Any classification attempt produces diagnostic labels that may create preconceptions, which bias perceptions of the labeled person's past and present behavior.

How can the biological and social-cognitive perspectives help us understand depressive disorders and bipolar disorder?

The biological perspective on depressive disorders and bipolar disorder focuses on genetic predispositions, abnormalities in brain structures and function (including those found in neurotransmitter systems), and nutritional (and drug) effects. The social-cognitive perspective views depression as an ongoing cycle of stressful experiences (interpreted through negative beliefs, attributions, and memories, often with relentless rumination) leading to negative moods, thoughts, and actions, thereby fueling new stressful experiences.

What is disociative identity disorder?

a rare dissociative disorder in which a person exhibits two or more distinct and alternating identities

How do the medical model and the biopsychosocial approach influence our understanding of psychological disorders?

The medical models assumes that psychological disorders have physical causes that can be diagnosed, treated, and often cured through therapy, sometimes in a hospital. The biopsychosocial perspective assumes that disordered behavior comes form the interaction of biological characteristics, psychological dynamics, and social-cultural circumstances. This approach has given rise to the vulnerability-stress model.

The psychodynamic and learning perspectives agree that dissociative identity disorder symptoms are ways of dealing with anxiety. How do their explanations differ?

The psychodynamic explanation of DID symptoms is that they are defenses against anxiety generated by unacceptable urges. The learning perspective attempts to explain these symptoms as behaviors that have been reinforced by relieving anxiety

People with psychological disorders are more likely to harm themselves. Are they also more likely to harm others?

Therapists and others apply disorder labels to communicate with one another using a common language, and to share concepts during research. Clients may benefit form knowing that they are not the only ones with these symptoms. The dangers of labelling people are that overly broad classifications may pathologize normal behavior, and the labels can trigger assumptions that will change people's behavior toward those labeled.

How do genes influences schizophrenia?

Twin and adoption studies indicate that the predisposition to schizophrenia is inherited. Multiple genes interact to produce schizophrenia. No environmental cause invariably produce schizophrenia, but environmental events (such as prenatal viruses or maternal stress) may turn on genes in those who are predisposed to this disorder

what is the vulnerability-stress model?

individual characteristics combine with environmental stressors to increase or decrease the likelihood of developing a psychological disorder

How do biological and psychological factors contribute to antisocial personality disorder?

Twin and adoption studies show that biological relatives of people with this disorder are at increased risk for antisocial behavior. Researchers have also observed differences in the brain activity and structure of antisocial criminals. Negative environmental factors, such as poverty or childhood abuse, may channel genetic traits such as fearlessness in more dangerous directions- toward aggression and away from social responsibility

what is PTSD?

a disorder characterized by haunting memories, nightmares, hypervigilance, avoidance of trauma-related stimuli, social withdrawal, jumpy anxiety, numbness of feeling, and/or insomnia that lingers for four weeks or more after a traumatic experiences.

What is schizophrenia?

a disorder characterized by the profound disruption of basic psychological processes; a distorted perception of reality; altered or blunted emotion; and disturbances in thought, motivation, and behavior

What is OCD?

a disorder characterized by unwanted persistent and repetitive thoughts obsessions or compulsions or both

What is bipolar disorder?

a disorder in which a person alternates between the hopelessness and lethargy of depression and the overexcited state of mania

what is major depressive disorder?

a disorder in which a person experiences, in the absence of drugs or another medical condition, two or more weeks with five or more symptoms, at least one of which must be either (1) depressed mood or (2) loss of interest or pleasure

what is chronic schizophrenia?

a form of schizophrenia in which symptoms usually appear by late adolescence or early adulthood. As people age, psychotic episodes last longer and recovery periods shorten

what is acute schizophrenia?

a form of schizophrenia that can begin at any age, frequently occurs in response to an emotionally traumatic event, and has extended recovery periods

what is a psychotic disorder?

a group of disorders marked by irrational ideas, distorted perception, and a loss of contact with reality.

what is mania?

a hyperactive, wildly optimistic state in which dangerously poor judgement is common

People with schizophrenia may hear voices urging self-destruction, an example of a(n) .

hallucinations

What is a psychological disorder?

a syndrome marked by a clinically significant disturbance in an individual's cognition, emotion regulation, or behavior

what is generalized anxiety disorder?

an anxiety disorder in which a person is continually tense, apprehensive, and in a state of autonomic nervous system arousal

what are phobias?

an anxiety disorder marked by a persistent, irrational fear and avoidance of a specific object, activity, or situation

What is anorexia nervosa?

an eating disorder in which a person maintains a starvation diet despite being significantly underweight; sometimes accompanied by excessive exercise

what is bulimia nervosa?

an eating disorder in which a person's binge eating is followed by inappropriate weight-loss promoting behavior, such as vomiting, laxative use, fasting, or excessive exercice

People with (anorexia nervosa/bulimia nervosa) continue to want to lose weight even when they are underweight. Those with (anorexia nervosa/bulimia nervosa) tend to have weight that fluctuates within or above normal ranges.

anorexia nervosa; bulimia nervosa

Many psychologists reject the disorders-as-illness view and instead contend that other factors may also be involved—for example, the person's level of stress and ways of coping with it. This view represents the __________ approach.

biopsychosocial

what is rumination?

compulsive fretting; overthinking about our problems and their causes

The learning perspective proposes that phobias are

conditioned fears

what are dissociative disorders?

controversial, rare disorders in which conscious awareness becomes separated from previous memories, thoughts, and feelings

A person with positive symptoms of schizophrenia is most likely to experience

delusions

Two major disorders that are found worldwide are schizophrenia and

depression

A lawyer is distressed by feeling the need to wash his hands 100 times a day. He has little time to meet with clients, and his colleagues are wondering about his competence. His behavior would probably be labeled disordered, because it is _________ , that is, it interferes with his day-to-day life.

dysfunctional or maladaptive

what are delusions?

false beliefs, often of persecution or grandeur, that may accompany psychotic disorders

Unfocused tension, apprehension, and arousal are symptoms of __________ disorder.

generalized anxiety

How do conditioning, cognition, and biology contribute to the feelings and thoughts that mark anxiety disorders, OCD, and PTSD?

the learning perspective views anxiety disorders, OCD and PTSD as products of fear conditioning, stimulus generalization, fearful-behavior reinforcement, and observational learning of others' fears and cognitions. The biological perspective considers genetic predispositions for high levels of emotional reactivity and neurotransmitter production; abnormal responses in the brain's fear circuits; and the role that fears of life-threatening dangers played in natural selection and evolution

what is epigenetics?

the study of the molecular mechanisms by which environments can influence genetic expression without a DNA change; supports the vulnerability-stress model

The gender gap in depression refers to the finding that (men's/women's) risk of depression is roughly double that of (men's/women's).

women's; men's