Notes From Reading
C HAPTER 14: PSYCHOLOGICAL D ISORDERS
I. Abnormal Behavior: Myths, Realities, and Controversies
A. The Medical Model Applied to Abnormal Behavior
1. Medical Model – proposes that it is useful to think of abnormal behavior as a
2. Szasz – Abnormal Behavior involves a deviation from social norms rather
than an illness. i.e. “problems of living” and not “medical problems”.
3. Diagnosis – distinguishing one illness from another
4. Etiology – apparent causation and developmental history of an illness.
5. Prognosis – forecast of probable course of an illness.
B. Criteria of Abnormal Behavior
1. Deviance – people are said to have a disorder if their behavior deviates from
what society considers acceptable (norms).
2. Maladaptive Behavior – people may be judged to have a disorder of their
everyday adaptive behavior is impaired i.e. substance abuse disorders.
3. Personal Distress – i.e. Depression/anxiety
4. Evolutionary Dysfunctions – a dysfunction occurs when an evolved
psychological mechanism does not perform its naturally selected function
adequately or effectively.
C. Stereotypes of Psychological Disorders
1. Psych Disorders are incurable
2. People with Psych disorders are often violent and dangerous.
3. People with psych. disorders behave in bizarre ways and are very different
from normal people.
D. Psycho-Diagnosis: The Classification of Disorders
1. DSM scale used to diagnose disorders.
2. Axis I (Clinical Syndromes) and Axis II (Personality Disorders and Mental
Retardation) used to make diagnosis of condition.
3. Axis III (General Medical Conditions), Axis IV (Psychosocial &
Environmental Problems) & Axis V (GAF Scale) – used to record
a. Axis V – current level of adaptive functioning.
E. Prevalence of Psych Disorders
1. Epidemiology – study of distribution of mental/physical disorders in a
2. Prevalence – the percentage of a population that exhibits a disorder during a
specific time period.
a. Lifetime prevalence – the percentage of people who endure a specific
disorder at any time in their lives.
3. 1/3 of population suffers from a psych disorder. Most commonly: anxiety,
substance use, and mood disorders.
II. Anxiety Disorders
1. Anxiety Disorder – class of disorders marked by feelings of excessive
apprehension and anxiety. 4 types – generalized anxiety disorder, phobic,
obsessive compulsive, and panic.
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C HAPTER 14: PSYCHOLOGICAL D ISORDERS
2. Disorders may not be mutually exclusive, many who have one develop
B. Generalized Anxiety Disorder
1. GAD – marked by a chronic, high level of anxiety that is not tied to any
specific threat. i.e. “free floating anxiety”.
2. Worry about minor matters related to family, finances, work, personal illness.
3. Physical symptoms: trembling, muscle tension, diarrhea, dizziness, heart
C. Phobic Disorder
1. Phobic. Disorder – marked by a persistent and irrational fear of an object or
situation that presents no realistic danger.
a. Phobias may be common, but people with Phobic Disorders have fears
which seriously interfere with everyday behavior.
2. Common Phobias incl. acrophobia (heights), claustrophobia, brontophobia
(storms), hydrophobia, and various insect/animal phobias.
3. People usually realize fears are irrational but are unable to remain calm when
confronted by a phobic object (or even imaging it).
D. Panic Disorder and Agorophobia
1. Panic Disorder – characterized by recurrent attacks of overwhelming anxiety
that usually occurs suddenly and unexpectedly. Accompanied by physical
a. Victim becomes apprehensive, refusing to leave house.
2. Agorophobia – fear of going out to public places – complication of Panic
a. Typically affects females.
E. Obsessive Compulsive Disorder
1. OCD – marked by persistent, uncontrollable intrusions of unwanted thoughts
(obsessing), and urges to engage in senseless rituals (compulsions)
2. Obsessions often center on inflicting harm on others, personal failure, suicide,
3. Victims may feel as though they’ve lost control of their mind.
4. Typically arises in early adulthood.
F. Etiology of Anxiety Disorders
1. Biological Factors
a. Concordance Rate – indicates the percentage of twin pairs or other pairs
of relations that exhibit the same disorders.
b. Twin studies suggest low genetic disposition to anxiety disorders.
c. Anxiety Sensitivity may make people vulnerable to anxiety disorders.
i.e. Some people are highly sensitive to internal physiological symptoms
of anxiety and prone to overreact with fear when they experience
d. Link between anxiety disorders and neurochemical activity in the brain.
2. Conditioning and Learning
a. Many anxiety response may be acquired through classical conditioning
and maintained through operant conditioning.
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C HAPTER 14: P SYCHOLOGICAL D ISORDERS
i. Originally neutral stimulus (snow) may be paired with frightening
event (avalanche) so it becomes a conditioned stimulus eliciting
anxiety. (Example of Classical Conditioning)
ii. Example of Operant Conditioning: Response – person avoids snow,
so avoidance response is negatively reinforced by a reduction in
b. Preparedness (Seligman) – people are biologically prepared by their
evolutionary history to acquire some fears easier than others.
c. Conditioned fears may be acquired through observational learning.
3. Cognitive Fears
a. Cognitive Theorists – people are more likely to suffer from problems w/
anxiety because they tend to: misinterpret harmless situations as
threatening, pay attention to perceived threats, and recall info that seems
b. i.e. some people are prone to anxiety disorders because they see threats
in every corner of their lives.
4. Personality – people who score high in nuerotism tend to be self conscious,
nervous, jittery, insecure, guilt prone, and gloomy. Correlated with anxiety
disorders and poorer prognosis of recovery.
5. Stress – anxiety disorders are stress related.
III. Somatoform Disorders
1. Psychosomatic Diseases – genuine physical ailments caused in part by
psychological factors, esp. emotional distress. i.e. Ulcers, asthma, high blood
a. Recorded on Axis III
2. Somatoform Diseases – physical ailments that can’t be fully explained by
organic conditions and are largely due to psychological factors (however,
they’re not “fake” illnesses).
B. Somatization Disorder
1. Somatization Disorder – marked by a history of diverse physical complaints
that appear to be psychological in origin.
a. Mostly in women. Coexists w/ anxiety disorders and depression
b. Victims report endless succession of minor physical ailments.
c. Unlikely diversity of health problems helps physicians diagnose it.
C. Conversation Disorder
1. Marked by significant loss of physical function (w/ no apparent organic basis)
usually in a single organ system.
a. Usual symptoms – partial/complete loss of vision, hearing, paralysis.
b. People with conversion disorder are usually suffering more severe
ailments that those w/ somatization disorder.
D. Hypochondriasis (or Hypochondria)
1. Characterized by excessive preoccupation with health concerns and incessant
worry about developing physical illness.
2. When physician gives normal diagnosis, victims are skeptical and go looking
for a new doctor.
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3. Frequently appears along with anxiety disorder and depression
E. Etiology of Somatoform Disorders
1. Personality Factors
a. Histrionic Personality – self centered, suggestible, excitable, emotional,
dramatic i.e. thrive on attention.
2. Cognitive Factors
a. Some people focus excessive attention on their internal physiological
processes and amplify normal bodily sensations into unnecessary
3. The Sick Role – indirect benefits of illness – avoiding confronting challenges,
1. Dissociative Disorder – people lose contact with portions of their
consciousness or memory, resulting in disruptions in their sense of identity.
B. Dissociative Amnesia and Fugue
1. Sudden loss of memory for important personal info that is too important to be
due to normal forgetting.
a. May be for a single traumatic event or extended period of time
surrounding the event