Ch 15: Psychological Disorders

Question 1

Dilemmas defining psychological disorders

Answer 1

1. Mental disorder as a violation of cultural standards

Ex: Cultural rules are specific to a particular time or group and can’t be universally defined

2. Mental disorder as emotion distress

Ex: Behaviour that is upsetting for one person may be acceptable to another (this does not include those who are dangerous to others, but are not troubled by their own actions)

3. Mental disorder as behaviour that is self-destructive or harmful to others

Ex: A person may report feeling as though nothing is wrong, but have destructive behaviour, like gambling

Question 2

Definition of mental disorder, as used by the textbook

Answer 2

Any behaviour or emotional state that causes an individual great suffering, is self-destructive, seriously impairs the person’s ability to work or get along with others, or endangers others in the community.

Question 3

The Diagnostic Statistical Manual of Mental Disorders (DSM)

Answer 3

Primary aim is descriptive. Disorders are clustered together in chapters:

1. Neurodevelopmental disorders
2. Emotional (internalizing) disorders
3. Somatic disorders
4. Externalizing disorders
5. Neurocognitive disorders
6. Personality disorders

Question 4

Problems with the DSM

Answer 4

1. The danger of overdiagnosis

Ex: ADHD behaviour can be similar to normal child behaviour that many kids grow out of

2. The power of diagnostic labels

Ex: Others see the person primarily in terms of the label, think the condition is permanent, or something is wrong with their personality, dismiss alternate explanations, or ignore changes in behaviour

3. The confusion of serious mental disorders with normal problems

Ex: Lumping together issues, such as having trouble writing clearly and schizophrenia, implies they are equally likely to require treatment

4. The illusion of objectivity and universality

Ex: Decisions about what to include in a disorder are based on group consensus rather than empirical evidence, so the decisions reflect prevailing attitudes and prejudice

Question 5

Advantages of the DSM

Answer 5

1. Many symptoms fall along a continuum, from mild to severe
2. If used correctly, it improves the reliability of diagnoses
3. Categories help clinicians distinguish between disorders that share certain symptoms (anxiety, irritability, delusions)

Question 6

How does the DSM reflect cultural differences:

Answer 6

1. Cultural syndromes: clusters of symptoms and attributes that end to co-occur among individuals in specific cultural groups, communities, or contexts
2. Cultural idioms of distress: ways of expressing distress that provide collective, shared ways of experiencing and talking about personal or social problems
3. Cultural explanations of distress, or perceived causes: labels, attributions, or features of an explanatory model that indicate culturally recognized meaning or etiology for symptoms, illness or distress

Question 7

Projective tests

Answer 7

Psychological tests used to infer a person’s motives, conflicts, and unconscious dynamics on the basis of the person’s interpretations of ambiguous stimuli

Ex: A person may be asked to draw a house, or to finish a sentence (“my father….”)

Lack reliability and validity, but can help therapists establish rapport with a client

Question 8

Generalized anxiety disorder

Answer 8

A continuous state of anxiety marked by feelings of worry and dread, apprehension, difficulties in concentration, and signs of motor tension

Question 9

Posttraumatic Stress Disorder (PTSD)

Answer 9

An anxiety disorder in which a person who has experienced a traumatic or life-threatening event has symptoms such as psychic numbing, reliving of the trauma, and increased physiological arousal

Question 10

Panic disorder

Answer 10

An anxiety disorder in which a person experiences recurring panic attacks, periods of intense fear, and feelings of impending doom or death, accompanied by physiological symptoms such as rapid heart rate and dizziness

Question 11

Phobia

Answer 11

An exaggerated, unrealistic fear of a specific situation, activity, or object

Question 12

Agoraphobia

Answer 12

A set of phobias, often set off by a panic attack, involving the basic fear of being away from a safe place or person

Question 13

Obsessive-compulsive disorder (OCD)

Answer 13

An anxiety disorder in which a person feels trapped in repetitive, persistent thoughts (obsessions) and repetitive, ritualized behaviours (compulsions), designed to reduce anxiety

Question 14

Major depression

Answer 14

A mood disorder involving disturbances in emotion (excessive sadness), behaviour (loss of interest in one’s usual activities), cognition (thoughts of hopelessness), and body function (fatigue and loss of appetite)

Question 15

Bipolar disorder

Answer 15

A mood disorder in which episodes of both depression and mania (excessive euphoria) occur

Question 16

Vulnerability-stress models

Answer 16

Approaches that emphasize how individual vulnerabilities interact with external stresses or circumstances to produce mental disorders

Question 17

Origins of depression

Answer 17

Studies show multiple factors must happen at the same time:

1. Genetic factors

Ex: Genes can affect levels of neurotransmitters in the brain (serotonin), or production of stress hormones (cortisol)

2. Life experiences and circumstances

Ex: Exposure to violence (in childhood, domestic violence), satisfaction with work, family, or status in life, and childhood maltreatment, or neglect

3. Losses of important relationships

Ex: Can set off depression in vulnerable individuals who have a history of insecure attachments, or rejection by parents or peers

4. Cognitive habits

Ex: Tendency toward negative thinking, the belief that the situation is permanent and uncontrollable, and rumination that fosters hopelessness

Question 18

Paranoid personality disorder

Answer 18

A disorder characterized by:

1. Unreasonable, excessive suspiciousness and mistrust
2. Irrational feelings of being persecuted by others

Question 19

Narcissistic personality disorder

Answer 19

A disorder characterized by:

1. An exaggerated sense of self-importance and self-absorption

Question 20

Borderline personality disorder

Answer 20

A disorder characterized by:

1. Intense but unstable relationships (alternate between idealizing and devaluing the partner)
2. A fear of abandonment by others
3. An unrealistic self-image
4. Emotional volatility

Question 21

Psychopathy

Answer 21

A personality disorder characterized by:

1. A lack of remorse, empathy, anxiety, and other social emotions
2. Use of deceit and manipulation
3. Impulsive thrill seeking

Question 22

Antisocial personality disorder (APD)

Answer 22

A personality disorder characterized by:

1. A lifelong pattern of irresponsible, antisocial behaviour such as lawbreaking, violence, and other impulsive, reckless acts

Question 23

Differentiating between psychopathy and antisocial personality disorder (APD)

Answer 23

People with psychopathy may or may not display “antisocial” behaviour (which all people with APD display)

People with APD can vary widely in their capacity for empathy, remorse, guilt, anxiety, and loyalty (whereas psychopaths lack the capacity for these traits)

Most psychopaths meet the requirements for APD, but most people with APD are not psychopaths

Question 24

Factors that contribute to psychopathy and APD

Answer 24

1. Abnormalities in the central nervous system

Ex: Psychopath’s inability to feel emotional arousal (empathy, guilt, fear of punishment) at a physiological level (no increase in skin’s electrical conductance) suggests they are unable to feel the anxiety necessary for learning their actions will have unpleasant consequences

2. Impaired frontal-lobe functioning

Ex: Impulsivity (in psychopathy and APD) could be related to having less grey matter in the frontal lobes, due to physical neglect, accidents, battering, or injury

3. Genetic influences

Ex: A genetic deficiency is linked to impulsivity (in psychopathy and APD), but only in those who were also maltreated in childhood

4. Environmental events

Ex: Environmental influences can alter the way genes express themselves. Poor nutrition in first 3 years of life, separation from the mother, and parental cruelty is linked to antisocial behaviour later in life

Question 25

Biological model of addiction

Answer 25

An approach which states that addiction is primarily due to a person’s biochemistry, metabolism, and genetic predisposition

Ex: ….

Question 26

Learning model of addiction

Answer 26

1. Addiction patterns vary according to cultural practices and the social environment.

Ex: ….

2. Policies of total abstinence tend to increase rates of addiction rather than reduce them

Ex: …

3. Not all addicts have withdrawal symptoms when they stop taking a drug

Ex: Those who successfully quit on their own, and have no withdrawal symptoms are somewhat invisible in the stats because they don’t seek treatment or enter recovery programs

Ex: The environment in which the drug is used (the setting) and a person’s expectations (mental set) have a powerful influence on the drug’s physiological and psychological effects

4. Addiction does not depend on properties of the drug alone, but also on the reasons for taking it; motives matter more than the chemical composition of the drug

Ex: People who are looking to escape the world can become addicted to any mood-altering drug. Whereas, people who are looking to relieve pain so they can function in the world are less likely to become addicted.