I. DEFINING PSYCHOLOGICAL DISORDER

1. What We Call It - Psychological disorders, as a class, are called many things. We use the term psychopathology, mental illness, behavior disorder, emotional disturbance, etc. They all mean roughly the same thing although the severity of the disorder may vary greatly. They share the following features however.


2. Distress - The person is experiencing some sort of negative reaction such as anxiety, depression, confusion, etc.


3. Atypical - Behavior deviates from what society believes is normal. They may react differently to normal stressors or engage in behaviors society considers deviant. This type of definition has led to some behaviors we may now not consider as mental illness to be labeled as pathology such as homosexuality. This was considered to be a mental illness until the 1970's.


4. Maladaptive - The disorder interferes with normal, every day functioning. They may not be able to hold a job, have normal social interactions, or care for themselves.


5. Unacceptable to Society - The behavior is in some way viewed negatively by society, as either objectionable or unacceptable. Again, homosexuality fell into this category.

II. HISTORY OF PERSPECTIVES ON MENTAL ILLNESS

1. Possessed by Demons - The earliest view of mental illness was that people suffering from it were possessed by demons. People were actually treated by drilling holes into their skulls to let the demons out. This procedure was called trephining.


2. Medical Model - The next view of mental disorder held that mental illness, just as physical illness, was the result of biological or medical factors. This view is still widely held today and it is probably valid for many mental disorders. It did lead to more humane treatment for the mentally ill.


3. Psychodynamic Perspective - This is the Freudian perspective. It holds that mental disorders are the result of unconscious urges or impulses.


4. Behavioral Perspective - This perspective holds that abnormal behavior is learned just like normal behavior. You are the product of your environment and through modeling, and social and cultural factors you learn to behave in a maladaptive manner.


III. DSM-IV

1. DSM-IV - The American Psychiatric Association publishes the "bible" of psychiatric diagnosis. It is the Diagnostic and Statistical Manual of Mental Disorders. It is usually just referred to as the DSM-IV, meaning that the version we are currently using is the third edition revised.

2. Diagnosis - What the DSM-IV does is give you a listing of behaviors that are associated with each classification. In order to use a diagnosis, the individual must meet the specific criteria set forth in the manual. It makes no claims to etiology (usually, PTSD is an exception) nor does it propose treatment.

3. Constantly Revised - As knowledge and attitudes change, so does the DSM-IV. As I mentioned, homosexuality was once considered a mental disorder, it no longer is. Other conditions like PMS (premenstrual Syndrome) and PTSD have been added in more recent versions. Others change. For example, what we now refer to as ADHD (Attention Deficit hyperactivity Disorder) was called Minimal Brain Dysfunction in DSM-II and Attention Deficit Disorder with or without Hyperactivity in DSM-III. DSM-IV is returning to the DSM-III categorization.


IV. ANXIETY DISORDERS

1. Anxiety - We have all experienced anxiety, it is part of everyday life. For anxiety to become a disorder it must be intense enough and of long enough duration to cause disruption in functioning. There are different types of anxiety disorders.

2. Generalized Anxiety Disorder - This is when the person is experiencing persistent and severe anxiety in most situations. In other words, they worry about everything and can't function. There is a constant fear, tension, and dread.

3. Panic Attacks - This is when an individual experiences sudden intense anxiety which temporarily renders them incapable of functioning. They are brief but intense but do not appear to be triggered by a particular object or event.

4. Phobias - A phobia is defined as an irrational fear of a particular object or event such as a fear of snakes, heights, etc. We talked about these bore when we discussed classical conditioning because they are though to be learned through classical conditioning. Everyone has fears but it does not become a phobia unless it interferes with normal functioning.

5. Obsessive-Compulsive Disorder (OCD) - An obsession is a thought that you can't get out of your mind. A compulsion is a ritualistic behavior that you engage in over and over again such as washing your hands over and over to get rid of germs. These are anxiety disorders because the obsession creates anxiety and the compulsion is your means to overcome anxiety. Both are maladaptive and disrupt normal functioning.

6. Treatment - Generalized anxiety disorders are usually treated with medication but phobias and OCD are usually treated behaviorally.


V. DISSOCIATIVE DISORDERS

1. Overview - These include disorders of though in which you lose identity or memory.

2. Psychogenic Amnesia - Amnesia is a loss of memory. while it usually happens due to some physical cause it is sometimes due to psychological causes such as experiencing trauma or extreme stress. When there is no physical cause we call it psychogenic amnesia. It usually involves a selective or localized forgetting but in rare instances it can involve a total loss of identity.

3. Multiple Personality - This is very rare, much rarer than you would imagine considering made for TV movies and defense arguments in criminal trials. This is when an individual possesses more than one distinct personality and they may not be aware of each other. This is still a controversial area and many people do not believe it actually exists.

VI. SOMATOFORM DISORDERS

1. Overview - This refers to disorders in which the person experiences physical symptoms in the absence of a physical etiology. It could be paralysis, deafness, or other physical disorder.


2. Hypochondriasis - You have all heard the term hypochondriac. That is what this is. They have an extreme fear of illness and while there is no physical illness, they constantly think they have something or that something (like cancer) is about to appear. To be a true hypochondriac you must be thinking of this constantly and it must disrupt your life. The key here is that there is really nothing wrong with you, you just think there is.

3. Conversion Disorder - In conversion disorder there is an actual impairment but there is no physical reason for it. Individuals have experienced blindness, deafness, and paralysis for no apparent physical reason. There have even been people who have appeared pregnant when they weren't. This is usually the result of extreme stress or trauma.


VII. sexual disorders

1. Sexual Dysfunction - These include disturbances in sexual desire, arousal, and ability to achieve orgasm. Disorders of desire include an aversion or a lack of interest in sex. Disorders of arousal include failure to achieve erection in males or lubrication or vaginal constriction in women. Disorders of orgasm include failure to, achieve orgasm or premature ejaculation in men. This does not include individuals who have these problems due to medical reasons.

2. Paraphilias - A paraphilia involves arousal only to inappropriate sexual objects. These include pedophilia which is desire to have sex with young children. Fetishes which is arousal to inanimate objects such as shoes, underwear, and even dead bodies. Transvesitism is an example of a fetish. Sadism and Masochism is when you get sexual pleasure from receiving or inflicting pain and humiliation. Exhibitionism and voyeurism are also pedaphilias.

3. Gender Identity - This is transsexualism in which you believe you were born with one sexual genitalia but your identity is with the other gender. It may result in a sex-change operation.


VIII. MOOD DISORDERS

1. Overview - These are also called affective disorders and they involve inappropriate affect such as depression or extreme elation.

2. Bipolar Disorder - This is also called manic-depressive and these individuals experience extreme mood swings. they vary from extreme depression to mania in which they are extremely excitable and energetic. They are usually treated with Lithium.

3. Major Depression - This is an overwhelming and persistent feeling of unhappiness and despair. They see life as hopeless and tend to withdraw and become lethargic. If a loved one dies you become depressed, that is normal. This is prolonged feeling and not the temporary reaction to an unhappy experience. It may even lead to suicide. Treatment is usually with medication combined with therapy.


IX. PERSONALITY DISORDERS

1. Overview - These are when a person has some personality trait which is inflexible and causes disruption of their everyday functioning. They include deviant behaviors and thoughts.

2. Antisocial Personality Disorder - These people are dangerous to others and they include delinquency, lying, and criminal activity. They are generally aggressive, irritable, impulsive, and fail to take responsibility for their actions. They are sometimes referred to as sociopaths. More common in males.

3. Histrionic Personality Disorder - This involves exaggerated displays of emotions. Even trivial events are blown up out of proportion to what happened. Everyday activities become major life events and they don't see why others don't share their concerns. More common in females.

4. Avoidant Personality Disorder - This is characterized by extreme shyness, poor self-esteem, and an inability to take criticism. They must have total acceptance so to avoid rejection they stay away from normal social interactions.

5. Dependent Personality Disorder - This is also the result of low self-esteem and they show extreme dependence on others. They let others tell them everything they are to do. They make no decisions on their own.



X. SCHIZOPHRENIA

1. Overview - These a the most serious psychological disorders and involve a lack of contact with reality. It is sometimes called a thought disorder and it is characterized by the following.

2. Disorder of Thought and Language - They do not think or speak like others. You could say it is weird. They often create their own words and they are hard to understand because their communication may consist of a bunch of seemingly unrelated statements. They also frequently have delusions which are firmly held beliefs that have no basis in reality. One of the more common type is delusions of persecution where you think everyone is out to get you. There are also delusions of grandeur where you think you are someone famous or powerful. Finally, there may be delusions of control in which they think that some evil force or God is controlling their brains.

3. Disturbance of Perception - They may not perceive the world in the same way as others. Most common is hallucinations where they have sensory experiences that have no basis in reality. The most common are auditory hallucinations where they hear voices but they may also have visual hallucination where they see things that are not there.

4. Disturbance of Emotion - The third key symptom of schizophrenia is inappropriate or unusual mood reactions. They may laugh at something sad or cry at a joke or do either for no reason at all.


XI. TYPES OF SCHIZOPHRENIA

1. Disorganized Schizophrenia - The most striking feature is a childlike behavior. They act like young children do by giggling, making faces, etc.

2. Catatonic Schizophrenia - This involves a disturbance in motor behavior. They may be totally immobile and sit or stand in a position for indefinite periods of times. They may also have a waxy flexibility. That is you can mold them like a doll and they will maintain that position.

3. Paranoid Schizophrenia - This is characterized by delusions of persecution. They think everyone is out to hurt them. This is the most common type of schizophrenia.