Chapter 14 – Reading Notes
Psychological or mental, disorders: Symptoms reflecting abnormalities of the mind.
Medical model: The conceptualization of psychological disorders as diseases that, like physical
diseases, have biological causes, defined symptoms, and possible cures.
Diagnosis: Clinicians seek to determine the nature of the patient’s mental disease by assessing
Symptoms: Behaviours, thoughts, and emotions suggestive of an underlying abnormal syndrome.
Syndrome: A coherent cluster of symptoms usually due to a single cause.
Diagnostic and Statistical Manual of Mental Disorders (DSM): A consensual diagnostic system for
therapists and researchers which was published in 1952.
o Early versions provided common language for talking about disorders, but diagnostic
criteria were still often vague and based on tenuous theoretical assumptions.
o The current fourth edition (DSM IV-TR): A classification system that describes the
features used to diagnose each recognized mental disorder and indicates how the
disorder can be distinguished from other, similar problems.
Each disorder is named and classified as though it were a distinct illness.
DSM-IV-TR takes into account 3 key elements that must be present for a cluster of symptoms to
qualify as a potential mental disorder:
o A disorder is manifested in symptoms that involve disturbances in behaviour, thoughts,
o The symptoms are associated with significant personal distress or impairment.
o The symptoms stem from an internal dysfunction (biological, psychological, or both).
Comorbidity: The co-occurrence of two or more disorders in a single individual.
Specifiable pattern of causes (or etiology) may exist for different psychological disorders.
Each category of psychological disorder is likely to have a common prognosis.
o Prognosis: A typical course over time and susceptibility to treatment and cure.
o However, it is rarely useful to focus on a single cause that is internal to the person and
that suggests a single cure.
Diathesis-stress model: A person may be predisposed for a psychological disorder that remains
unexpressed until triggered by stress.
Intervention-causation fallacy: Search for biological causes of psychological disorders in the
brain and body tends to invite particular error in explanation.
o Involves assumption that if a treatment is effective, it must address the cause of the
14.4 The negative stereotypes and stigma such as mental disorder is a sign of personal weakness or
the idea that psychiatric patients are dangerous explains why nearly 70% of people with
diagnosable psychological disorders do not seek treatment.
Labelling someone as having a psychological disorder makes it hard for the patient to return to
life as a nonpatient.
o People given such label may come to view themselves not just as mentally disordered,
but as hopeless and worthless.
o Causes these people to develop an attitude of defeat and as a result, fail to work toward
their own recovery.
The study of psychological disorders follows a medical model in which symptoms are
understood to indicate an underlying disorder.
Many psychological disorders arise from multiple causes or as a result of the interaction of
diathesis (internal predisposition) and stress. It is a common error to assume that an
intervention that cures a disorder reflects the cause of the disorder.
Anxiety disorder: The class of mental disorder in which anxiety is the predominant feature.
o Generalized anxiety disorder
o Phobic disorders
o Panic disorder
o Obsessive-compulsive disorder
Generalized anxiety disorder (GAD): Called generalized because the unrelenting worries are not
focused on any particular threat. Chronic excessive worry is accompanied by three or more of
the following symptoms – restlessness, fatigue, concentration problems, irritability, muscle
tension, and sleep disturbance.
o Occurs more frequently in lower socioeconomic groups and is approximately twice as
common in women as in men.
Phobic disorders: Marked, persistent, and excessive fear and avoidance of specific objects,
activities, or situations.
Specific phobia: An irrational fear of a particular object or situation that markedly interferes
with an individual’s ability to function.
o Specific phobias fall into 5 categories:
Animals (dogs, cats, rates, snakes, spiders, etc.)
Natural environment (heights, darkness, water, storms, etc.)
Situations (bridges, elevators, tunnels, enclosed places, etc.)
Blood, injections, and injury
Other phobias, including illness and death
o Specific phobias are more common among women than among men (ratio 4:1).
Social phobia: An irrational fear of being publicly humiliated or embarrassed.
o Emerges between early adolescence and the age of 25.
o About 11% of men and 15% of women. o Higher rates among people who are undereducated, have low incomes, or both.
Preparedness theory: People are instinctively predisposed toward certain fears.
Individuals with phobias sometimes show abnormally high levels of activity in the amygdala
(linked to development of emotional associations).
Panic disorder: The sudden occurrence of multiple psychological and physiological symptoms
that contribute to a feeling of stark terror.
Symptoms typically last only a few minutes and include shortness of breath, heart palpitations,
sweating, dizziness, depersonalization or derealisation, and a fear that one is going crazy or
about to die.
o Depersonalization: A feeling of being detached from one’s body.
o Derealisation: A feeling that the external world is strange or unreal.
Agoraphobia: A specific phobia involving a fear of venturing into public places.
Especially prevalent among women and are twice as likely to be diagnosed with it as are men.
Obsessive-compulsive disorder (OCD): Repetitive, intrusive thoughts (obsessions) and ritualistic
behaviours (compulsions) designed to fend off those thoughts interfere significantly with an
Approximately 1.3% of people will develop OCD sometimes in their lives with lower rates in
Women are more susceptible than men, but the difference is not large.
Most common obsessions involve contamination, aggression, death, sex, disease, orderliness,
Compulsion typically that the form of cleaning, checking, repeating, ordering/arranging, and
OCD typically derive from concerns that could pose a real threat.
People with anxiety disorders have irrational worries and fears that undermine their ability to
GAD involves a chronic state of anxiety, whereas phobic disorders involve anxiety tied to a
specific object or situation.
People who suffer from panic disorder experience a sudden and intense attack of anxiety that is
terrifying and can lead them to become agoraphobic and housebound for fear of public
People with obsessive-compulsive disorder experience recurring, anxiety-provoking thoughts
that compel them to engage in ritualistic, irrational behaviour.
Moods are relatively long-lasting, nonspecific emotional states.
o Nonspecific means that we often have no idea what has caused a mood.
Mood disorders: Mental disorders that have mood disturbance as their predominant feature.
o Take two main forms: Depression and bipolar disorder.
14.13 Major depressive disorder: A several depressed mood that lasts 2 or more weeks and is
accompanied by feelings of worthlessness and lack of pleasure, lethargy, and sleep and appetite
Dysthymia: The same cognitive and bodily problems as in depression are present, but they are
less severe and last longer, persisting for at least 2 years.
Double depression: A moderately depressed mood that persists for at least 2 years and is
punctuated by periods of major depression.
Seasonal affective disorder (SAD): Recurrent depressive episodes in a seasonal pattern.
Women are diagnosed with depression at a rate twice that of men.
Socioeconomic standing has invoked explanation for women’s heightened risk.
Sex differences in hormones are another possibility Estrogen, androgen, and progesterone
o Some women experience postpartum depression (depression following childbirth) due
to changing hormone balances.
It is also possible that higher rate of depression reflects greater willingness by women to seek
out for help which leads to higher rates of diagnosis among women.
Women’s tendency to accept, disclose, and ruminate on their negative emotions in contrast
with men’s tendency to deny negative emotions and engage in self-distraction such as work and
Depression may involve diminished activity in the left prefrontal cortex and increased activity in
the right prefrontal cortex (areas of the rain involved in the processing of emotions).
o Severely depressed individuals who do not have brain damage often show diminished
activity in the anterior (prefrontal) regions of the cerebral hemispheres (especially on
the left side).
These abnormal patterns may be effects of the mood disturbance, or may cause
people to be more susceptible to depression.
Helplessness theory: Individuals who are prone to depression automatically attribute negative
experiences to causes that are internal, stable, and global.
Bipolar disorder: An unstable emotional condition characterized by cycles of abnormal,
persistent high mood (mania) and low mood (depression).
o In about 2/3 of patient, manic episodes immediately precede or immediately follow
o The manic phase last at least a week to meet DSM requirements.
Mood can be elevated, expansive, or irritable.
Other prominent symptoms include grandiosity, decreased need for sleep,
talkativeness, racing thoughts, distractibility, and reckless behaviour.
Psychotic features such as hallucinations and delusions may be present (causing
the disorder to be misdiagnosed as schizophrenia).
The risk for bipolar disorder is abou