Psychological
Disorders
Overview of Psychological
Disorders
People suffering from psychotic disorders have “retreated
from reality.” That is, they suffer from hallucinations and
delusions and are socially withdrawn. Psychotic disorders
are severely disabling and often lead to hospitalization.
Typically, psychotic patients cannot control their thoughts
and actions.
Organic Mental Disorders
Disorders are problems caused by brain pathology;
that is, by drug damage, diseases of the brain,
injuries, poisons, and so on. A person with an
organic disorder may have severe emotional
disturbances, impaired thinking, memory loss,
Table 14.3 • Some Selected Categories of Psychopathology
Mood disorders
are primarily defined by the presence of extreme, intense, and
long-lasting emotions. Afflicted persons may be manic,
meaning agitated, elated, and hyperactive, or they may be
depressed. Some people with mood disorders alternate
between mania and depression, and they may have psychotic
symptoms as well.
Anxiety disorders
Marked by fear or anxiety and by distorted behavior. Some
anxiety disorders involve feelings of panic. Others take the
form of phobias (irrational fears) or just overwhelming
anxiety and nervousness. Two additional anxiety disorders are
posttraumatic stress disorder and acute stress dis-order.
Obsessive-compulsive behavior patterns are also associated
with high anxiety.
Dissociative disorder
may have temporary amnesia or multiple personalities. Also
included in this category are frightening episodes of
depersonalization, in which people feel like they are outside
their bodies, are behaving like robots, or are lost in a dream
world.
Somatoform (so-MAT-oh-form) disorder
is a mental health condition that causes an individual to
experience physical bodily symptoms in response to
psychological distress. Somatic symptom disorder is
diagnosed when a person has a significant focus on physical
symptoms, such as pain, weakness or dizziness, to a level
that results in major distress and/or problems with daily
activities.
Personality disorders
are deeply ingrained, unhealthy personality patterns. Such
patterns usually appear in adolescence and continue
through much of adult life. They include paranoid(overly
suspicious), narcissistic (self-loving), dependent, borderline,
and antisocial personality types, as well as others.
Sexual and gender identity disorders
include any of a wide range of difficulties with sexual identity, deviant sexual
behavior or sexual adjustment. In gender identity disorders, sexual identity does
not match a person’s physical sex and the person may seek a sex-change
operation. Deviations in sexual behavior known as paraphilias include
exhibitionism, fetishism, voyeurism, and so on.
Substance-related disorders
involve abuse of, or dependence on, psychoactive drugs. Typical
culprits include alcohol, barbiturates, opiates, cocaine,
amphetamines, hallucinogens, marijuana, and nicotine. A person
with a substance-related disorder cannot stop using the drug and
may also suffer from withdrawal symptoms, delirium, dementia,
amnesia, psychosis, emotional outbursts, sexual problems, and sleep
disturbances.
NATURE OF PSYCHOSIS
People who suffer from delusions hold false beliefs that
they insist are true, regardless of how much the facts
contradict them. Collection of symptoms that affect the
mind, where there has been some loss of contact with
reality. During an episode of psychosis, a person's thoughts
and perceptions are disrupted and they may have difficulty
recognizing what is real and what is not.
DIFFERENT KIDS OF DE LUSIONS
Depressive delusions - in which people feel that they have committed horrible crimes or
sinful deeds.
Somatic delusions - such as believing your body is “rotting away” or that it is emitting foul
odors
Delusions of grandeur - in which people think they are extremely important.
Delusions of influence – in which people feel they are being controlled or influenced by
others or by unseen forces
Delusions of persecution - persecution, in which people believe that others are “out to get
them
Delusions of reference - in which people give great personal meaning to unrelated events.
For instance, delusional people sometimes think that television programs are giving them a
special personal message
Hallucinations
are imaginary sensations, such as seeing,
hearing, or smelling things that don’t exist
in the real world.
Warning Signs of Psychotic Disorders
and Major Mood Disorders
Organic Psychosis
In a sense, all psychoses are partly organic, involving
physical changes in the brain. However, the general term
organic psychosis is usually reserved for problems
involving clear-cut brain injuries or diseases. For example,
poisoning by lead or mercury can damage the brain and
cause hallucinations, delusions, and a loss of emotional
control
Dementia
The most common organic problem is dementia (duh-MEN-sha), a
serious mental impairment in old age caused by deterioration of the
brain In dementia, we see major disturbances in memory, reasoning,
judgment, impulse control, and personality. This combination
usually leaves people confused, suspicious, apathetic, or withdrawn.
Some common causes of dementia are circulatory problems,
repeated strokes, or general shrinkage and atrophy of the brain. The
majority of people who suffer from dementia slowly lose their
mental abilities without becoming psychotic.
Alzheimer’s disease
The most common cause of dementia is Alzheimer’s disease
(ALLS-hi-merz), one of the most fearsome problems of aging.
Alzheimer’s victims slowly lose the ability to work, cook, drive, read,
write, or do arithmetic. Eventually they are mute and bed- ridden.
Alzheimer’s disease appears to be caused by unusual webs and
tangles in the brain that damage areas important for memory and
learning
The main feature of
delusional disorders is the
presence of deeply held false
beliefs,
which may take the following
forms :
Erotomanic type: In this disorder, people have erotic delusions that they are
loved by another person, especially by some-one famous or of higher status. As
you might imagine, some celebrity stalkers suffer from erotomania.
Grandiose type: In this case, people suffer from the delusion that they have
some great, unrecognized talent, knowledge, or insight. They may also believe
that they have a special relationship with an important person or with God or
that they are a famous person. (If the famous person is alive, the deluded per-
son regards her or him as an imposter.)
Jealous type: An example of this type of delusion would behaving an all-
consuming, but unfounded, belief that your spouse or lover is unfaithful.
Persecutory type: Delusions of persecution involve belief
that you are being conspired against, cheated, spied on,
followed, poisoned, maligned, or harassed.
Somatic type: People suffering from somatic delusions
typically believe that their bodies are diseased or rotting, or
infested with insects or parasites, or that parts of their
bodies are defective.
PARANOID PSYCHOSIS
Centers on delusions of persecution. Paranoid individual soften
believe that they are being cheated, spied on, followed, poisoned,
harassed, or plotted against. Usually they are intensely suspicious,
believing they must be on guard at all times. It is difficult to treat
people suffering from paranoid delusions because it is almost
impossible for them to accept that they need help.
Schizophrenia
is marked by delusions, hallucinations, apathy, thinking abnormalities, and a
“split "between thought and emotion. In schizophrenia, emotions may become
blunted or very inappropriate. For example, if a person with schizophrenia is
told his mother just died, he might smile, Schizophrenic delusions may include
the idea that the person’s thoughts and actions are being controlled, that
thoughts are being broadcast (so others can hear them), that thoughts have
been “inserted” into the person's mind, or that thoughts have been removed. In
addition, schizophrenia involves withdrawal from contact with others, a loss of
interest in external activities, a breakdown of personal habits, and an inability to
deal with daily events
SUBTYPES OF SCHIZOPHRENIA
Disorganized type - Schizophrenia marked by incoherence, grossly
disorganized behavior, bizarre thinking, and flat or grossly
inappropriate emotions.
Catatonic type - Schizophrenia marked by stupor; rigidity;
unresponsiveness; posturing; mutism; and, sometimes, agitated,
purposeless behavior.
Paranoid type - Schizophrenia marked by a preoccupation with
delusions or by frequent auditory hallucinations related to a single
theme.
Undifferentiated type - Schizophrenia in which there are
prominent psychotic symptoms, but none of the specific features of
catatonic, disorganized, or paranoid types.
Disorganized Schizophrenia
Describes a person with schizophrenia who has symptoms
including: disorganized thinking. unusual speech
patterns. flat affect. emotions that don't fit the situation In
disorganized schizophrenia, personality disintegration is
almost complete: Emotions, speech, and behavior are all
highly disorganized.
Catatonic Schizophrenia
The catatonic person seems to be in a state of total
panic effects the way you move in extreme ways. You
might stay totally still and mute. Or you might get
hyperactive for no reason. The new name for this
condition is schizophrenia with catatonic
Paranoid Schizophrenia
Paranoid schizophrenia is the most common schizophrenic
disorder. As in paranoid delusional disorders, paranoid
schizophrenia centers on delusions of grandeur and
persecution. However, paranoid schizophrenics also
hallucinate, and their delusions are more bizarre and
unconvincing than those in a delusional disorder
Undifferentiated Schizophrenia
Schizophrenia lacking the specific features of catatonic,
disorganized, or paranoid types In reality, patients may shift
from one pattern to another at different times. Many
patients, therefore, are simply classified as suffering from
undifferentiated schizophrenia, in which the specific
features of catatonic, disorganized, or paranoid types are
missing.
Major Mood Disorders
Major mood disorders are characterized by emotional extremes. The
person who only goes “down” emotionally suffers from a major
depressive disorder. During major depressive episodes everything
looks bleak and hopeless. The person has feelings of failure,
worthlessness, and total despair. Suffering is intense, and the person
may become extremely subdued, withdrawn, or intensely suicidal.
Suicide attempted during a major depression is rarely a “plea for help.”
Usually, the person intends to succeed and may give no prior warning.
Bipolar I disorder
A mood disorder in which a person has episodes of
mania (excited, hyperactive, energetic, grandiose
behavior) and also periods of deep depression.
disorder, people experience both extreme mania and
deep depression. During manic episodes, the person
is loud, elated, hyperactive, grandiose, and energetic.
Bipolar II disorder
A mood disorder in which a person is mostly depressed
(sad, despondent, guilt ridden) but has also had one or
more episodes of mild mania (hypomania).The person is
mostly sad and guilt rid-den, but has had one or more
mildly manic episodes (called hypo-mania). That is, in a
bipolar II disorder both elation and depression occur, but
the person’s mania is not as extreme as in a bipolar I.
Postpartum Depression
Moderately severe depression that begins within 3 months following
childbirth. Typical signs of postpartum depression are mood swings,
despondency, feelings of inadequacy, and an inability to cope with
the new baby. Unlike other types of depression, postpartum
depression also features unusually high levels of restlessness and
difficulty concentrating strong feelings of sadness, anxiety (worry)
and tiredness that last for a long time after giving birth.
Seasonal Affective Disorder
Depression that only occurs during the fall and winter
months. Almost anyone can get a little depressed when days
are short, dark, and cold. But when a person’s symptoms are
lasting and disabling, the problem may be Seasonal Affective
Disorder. Symptoms are:
Fatigue: Oversleeping and difficulty staying awake: Craving:
Inability to cope: Social withdrawal:
Endogenous Depression
Depression that appears to be produced from within
(perhaps by chemical imbalances in the brain) such
as serotonin, dopamine rather than as a reaction to
life events.
Adjustment Disorders
occur when ordinary stresses push people beyond
their ability to cope with life. Examples of such
stresses are losing a job, intense marital strife, and
chronic physical illness. People suffering from an
adjustment disorder may be extremely irritable,
anxious, apathetic, or depressed.
Generalized Anxiety Disorder
A person with a generalized anxiety disorder has been extremely anxious
and worried for at least 6 months. Sufferers typically complain of sweating,
a racing heart, clammy hands, dizziness, upset stomach, rapid breathing,
irritability, and poor concentration.
Typical signs are: You have been extremely anxious or worried for 6
months.
Panic Disorder (Without Agoraphobia)
People are highly anxious and also feel sudden, intense, unexpected
panic. During panic attack, victims experience chest pain, a racing
heart, dizziness, choking, feelings of unreality, trembling, or fears of
losing control. Many believe that they are having a heart attack, are
going insane, or are about to die.
Symptoms are: You are anxious much of the time and have sudden
panic attacks.
Panic Disorder (with Agoraphobia)
A chronic state of anxiety and brief moments of sudden
panic. The person fears that these panic attacks will occur in
public places or unfamiliar situations.
Symptoms are: You have panic attacks and are afraid that
they might occur in public places, so you rarely leave home.
Agoraphobia
Can also occur without panic. In this case, people fear that
something extremely embarrassing will happen if they leave home
or enter an unfamiliar situation. For example, an agoraphobic
person may refuse to go outside because he or she fears having a
sudden attack of dizziness, or diarrhea, or shortness of breath.
Typical sign of trouble are: You fear that something extremely
embarrassing will happen if you leave home (but you don’t have
panic attacks).
Specific Phobia
The person’s fear, anxiety, and avoidance are
focused on particular objects, activities, or
situations. People affected by phobias recognize
that their fears are unreasonable, but they
cannot control them.
• Acrophobia — fear of heights
• Astraphobia — fear of storms, thunder, lightning
• Aquaphobia — fear of being on or in water
• Aviophobia — fear of airplanes
• Claustrophobia — fear of closed spaces
• Agoraphobia — fear of crowds
Social Phobia
In a social phobia, people fear situations in which they can be observed,
evaluated, embarrassed, or humiliated by others. This leads them to avoid
certain social situations, such as eating, writing, using the rest room, or speaking
in public.
Typically signs of trouble: You fear social situations where people can
watch, criticize, embarrass, or humiliate you.
Obsessive-Compulsive Disorder
People who suffer from obsessive-compulsive disorder are pre-
occupied with certain distressing thoughts and feel compelled to
perform certain behaviors.
Typical signs of trouble: Your thoughts make you extremely
nervous and compel you to rigidly repeat certain actions or routines.
Acute Stress Disorder
A psychological disturbance lasting up to1
month following stresses that would produce
anxiety in anyone who experienced them. You
are tormented for less than a monthly the
emotional aftereffects of horrible events you
have experienced.
Posttraumatic Stress Disorder
(PTSD)
A real disorder that develops when a person has experienced or
witnessed a scary, shocking, terrifying, or dangerous event. These
stressful or traumatic events usually involve a situation where
someone's life has been threatened or severe injury has occurred.
You are tormented for more than a monthly the emotional
aftereffects of horrible events you have experienced.
• SYMPTOMS
• Hypervigilance
• Intrusive Thoughts
• Irritability
• Loss of Interest
• Sleep Difficulties
• Trauma
Dissociative Disorders
Are mental health conditions that involve experiencing a
loss of connection between thoughts, memories, feelings,
surroundings, behavior and identity. These conditions
include escape from reality in ways that are not wanted and
not healthy. This causes problems in managing everyday
life.
3 Examples of Dissociative Disorders
Dissociative amnesia - is an inability to recall one's name, address,
or past.
Dissociative fugue (FEWG) - (FEWG) involves sudden,
unplanned travel away from home and confusion about personal
identity. Dissociations are often triggered by highly traumatic events
Dissociative Identity Disorder - disorder has two or more
separate identities or personality states or presence of two or more
distinct personalities (multiple personality).
Typically, the person feels ill much of the time and
visits doctors repeatedly. Most sufferers take medicines
or other treatments, but no physical cause can be found
for their distress. Similarly, a person with pain disorder
is disabled by pain that has no identifiable physical
basis.
Somatoform Disorders
Afflicted persons have numerous physical complaints. Typically, they
have consulted many doctors, but no organic cause for their distress
can be identified. These people are pre-occupied with bodily
functions, such as their heartbeat or breathing or digestion. Minor
physical problems — even a small sore or an occasional cough may
convince them that they have cancer or some other dreaded disease.
Typically, they can’t give up their fears of illness, even if doctors can
find no medical basis for their complaints
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