Chapter 13

Psychological Disorders

“To study the abnormal is the best way of understanding the

normal.”William James

Philosopher that wrote a textbook on psychology in 1879.

According to the World Health Organization…

450 million people throughout the world have psychological

disorders.

Questions considered in the chapter:

• How should we define psychological disorders?• How should we understand disorders—as

sicknesses that need to be diagnosed and cured, or as natural responses to a troubling environment?

• How should we classify psychological disorders?• Can we classify people in a way that allows us to

help people without stigmatizing them with labels.

Psychological Disorders

Ongoing patterns of thoughts, feelings, and actions that are deviant,

distressful, and dysfunctional.

Deviant?

• Standards for deviant behavior vary by context and by culture.

• Standards for deviance also vary with time.

Why was homosexuality removed from the American Psychiatric

Association’s listing of disorders?

More and more of its members no longer viewed it as a

psychological problem.

Attention Deficit Hyperactivity Disorder is now diagnosed more

often than it once was.

ADHD

Psychological disorder marked by the appearance by age 7 of one or more of the three key symptoms: extreme inattention,

hyperactivity, and impulsivity.

To be considered a disorder…

• The deviant behavior usually causes the person distress. This is even more so when behaviors are judged to be a harmful dysfunction.

• Dysfunction is key to defining a disorder.

Thinking Critically about ADHD.

• Symptoms:– Extreme inattention– Hyperactivity– Impulsivity

10% of American children between 13-17 are being medicated for ADHD.

A diagnosis often depends upon a referral which is mostly done by

classroom teachers.• There is an increased awareness of the

disorder which may also be partially responsible for the increase.

• ADHD is a neurobiological disorder– Certain brain activity patterns are shown in

neuroimaging.

• ADHD is believed to be inherited. The gene is not yet isolated.

• It is often treated with Ritalin and Adderall which are stimulants yet calm hyperactivity.

• Behavior Modification can also help manage behaviors associated with ADHD.

• Maturation can help ease the symptoms too.

What factors can help us understand psychological

disorders?During the Middle Ages we might

say that “the Devil made me do it.”

Medical Model

• Philippe Pinel (1745 – 1826) in France said it is a sickness of the mind rather than madness. He “unchained” those with the diagnosis and use a more moral treatment.

• Medical world looked for physical causes of mental disorders and treatments.

• Medical Model becomes more humane and prominent as is demonstrated in the changes in terminology related to disorders by calling the changes the Mental Health Movement.

Mental Illness (psychopathology)

Needs to be diagnosed on the basis of its symptoms and cured through

therapy which may include treatment in a psychiatric hospital.

Medical Model

It gains credibility by discovering that genetically influenced abnormalities in

brain structure and biochemistry contribute to the disorders.

Biopsychosocial Approach

• Belief that medical model is incomplete.

• We must pay attention to– Genetic predispositions and physiological

states– Inner psychological dynamics– Social and cultural circumstances

Classifying Psychological Disorders

How and why do clinicians classify psychological disorders?

Classification of disorders and describing the symptoms.

Diagnostic classification aims not only to describe a disorder but also to predict its future course, imply appropriate treatment, and

stimulate research onto its causes.

DSM-IV-TR = APA’s Diagnostic and Statistical Manual of Mental

Disorders, Fourth Edition.

WHO’s International Classification of Diseases (ICD-10) which covers both medical and psychological

disorders.

North American health insurance companies usually require a DSM-IV-TR diagnosis before they pay for

therapy.

• 26% in any given year and 46% at some time in their lives meet the criteria of at least one disorder.

Positive Psychology Movement

• Assesses six clusters of 24 strengths. These are used to help clients identify what they believe makes a good life.– Wisdom and Knowledge– Courage– Humanity– Justice– Temperance (forgiveness, mercy, self regulation)– Transcendence (appreciation of beauty & excellence,

gratitude, humor, spirituality)

Labeling Psychological Disorders

Why do some psychologists criticize the use of diagnostic

labels?

-Understand underlying causes

-Discern effective treatment programs

Labels can…

• Change perceptions

• Serve as self-fulfilling prophecies

• Have lives and an influence of its own.

People can be stigmatized by a label.

In real life, people with disorders are more likely to be the victims

of violence rather than perpetrators.