CHAPTER R EVIEW: Psychological Disorders
Perspectives on Psychological Disorders
1: How should we draw the line between normality and disorder?
- Psychologists and psychiatrists consider behavior disordered when it is deviant,
distressful, and dysfunctional. The definition of deviant varies with context and
culture. It also varies with time; for example, some children who might have been
judged rambunctious a few decades ago now are being diagnosed with attention-
deficit hyperactivity disorder.
2: What perspectives can help us understand psychological disorders?
- The medical model assumes that psychological disorders are mental illnesses that
can be diagnosed on the basis of their symptoms and cured through therapy,
sometimes in a hospital. The bio psychosocial perspective assumes that
disordered behavior, like other behavior, arises from genetic predispositions and
physiological states; inner psychological dynamics; and social cultural
3: How and why do clinicians classify psychological disorders?
- The fourth edition (text revised) of the American Psychiatric Association’s
Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) provides
diagnostic labels and descriptions that aid mental health professionals by
providing a common language and shared concepts for communications and
research. Most U.S. health insurance organizations require DSM-IV diagnoses
before they will pay for therapy.
4: Why do some psychologists criticize the use of diagnostic labels?
- Labels can create preconceptions that unfairly stigmatize people and can bias our
perceptions of their past and present behavior. One label, “insanity”—used in
some legal defenses— raises moral and ethical questions about how a society
should treat people who have disorders and have committed crimes.
5: What are anxiety disorders, and how do they differ from ordinary worries and
- Anxiety is classified as a psychological disorder only when it becomes
distressing or persistent, or is characterized by maladaptive behaviors intended
to reduce it. 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 or situation.
Persistent and repetitive thoughts (obsessions) and actions (compulsions)
characterize obsessive-compulsive disorder. Symptoms of post-traumatic stress
disorder include four or more weeks of haunting memories, nightmares, social
withdrawal, jumpy anxiety, and sleep problems following some traumatic and
6: What produces the thoughts and feelings that mark anxiety disorders?
- Freud viewed anxiety disorders as the manifestation of mental energy associated
with the discharge of repressed impulses. Psychologists working from the
learning perspective view anxiety disorders as a product of fear conditioning,
stimulus generalization, reinforcement of fearful behaviors, and observational
learning of others’ fear. Those working from the biological perspective consider
the role that fears of life-threatening animals, objects, or situations played in
natural selection and evolution; the genetic inheritance of a high level of
emotional reactivity; and abnormal responses in the brain’s fear circuits.
7: What are somatoform disorders?
- Somatoform disorders present a somatic (bodily) symptom— some
physiologically unexplained but genuinely felt ailment. With conversion disorder,
anxiety appears converted to a physical symptom that has no reasonable
neurological basis. Hypochondriasis is the more common interpretation of normal
sensations as a dreaded disorder.
8: What are dissociative disorders, and why are they controversial?
- Dissociative disorders are conditions in which conscious awareness seems to
become separated from previous memories, thoughts, and feelings. Skeptics note
that dissociative identity disorder, commonly known as multiple personality
disorder, increased dramatically in the late twentieth century, that it is rarely
found outside North America, and that it may reflect role-playing by people who
are vulnerable to therapists’ suggestions. Others view this disorder as a
manifestation of feelings of anxiety, or as a response learned when behaviors are
reinforced by reductions in feelings of anxiety.
9: What are mood disorders, and what forms do they take?
- Mood disorders are characterized by emotional extremes. A person with major
depressive disorder experiences two or more weeks of seriously depressed moods
and feelings of worthlessness, takes little interest in most activities, and derives
little pleasure from them. These feelings are not caused by drugs or a medical
condition. People with the less common condition of bipolar disorder experience
not only depression but also mania, episodes of hyperactive and wildly optimistic
10: What causes mood disorders, and what might explain the Western world’s
rising incidence of depression among youth and young adults?
- The biological perspective on depression focuses on genetic predispositions and
on abnormalities in brain structures and functions (including those found in
neurotransmitter systems). The social-cognitive perspective examines the
influence of cyclic self-defeating beliefs, learned helplessness, negative