Chapter Review: Psychological Disorders

Test yourself by taking a moment to answer each of these Learning Objective Questions (repeated here from within the chapter). Research suggests that trying to answer these questions on your own will improve your long-term memory of the concepts (McDaniel et al., 2009).

What Is a Psychological Disorder?

Question 13.17

How should we draw the line between normal behavior and psychological disorder?

  • According to psychologists and psychiatrists, psychological disorders are marked by a clinically significant disturbance in an individual’s cognition, emotion regulation, or behavior.

Question 13.18

Why is there controversy over attention-deficit/hyperactivity disorder?

  • A child who displays extreme inattention, hyperactivity, and impulsivity may be diagnosed with attention-deficit/hyperactivity disorder (ADHD) and treated with medication and other therapy.
  • The controversy centers on whether the growing number of ADHD cases reflects overdiagnosis or increased awareness of the disorder, and on the long-term effects of stimulant-drug treatment

Question 13.19

How is our understanding of psychological disorders affected by whether we use a medical model or a biopsychosocial approach?

  • The medical model assumes that psychological disorders are mental illnesses with physical causes that can be diagnosed, treated, and, in most cases, cured through therapy, sometimes in a hospital.
  • The biopsychosocial approach assumes that disordered behavior comes from the interaction of biological characteristics (genes and physiology), psychological dynamics, and social-cultural circumstances.

Question 13.20

How and why do clinicians classify psychological disorders, and why do some psychologists criticize the use of diagnostic labels?

  • The American Psychiatric Association’s DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) lists and describes psychological disorders.
  • Diagnostic labels provide a common language and shared concepts for communication and research.
  • Some critics believe the DSM editions have become too detailed and extensive.
  • Labels can create preconceptions that cause us to view a person differently, and then look for evidence to confirm that view.

Anxiety Disorders, OCD, and PTSD

Question 13.21

What are the main anxiety disorders, and how do anxiety disorders differ from the ordinary worries and fears we all experience?

  • It’s common to feel uneasy; when those feelings are intense and persistent they may be classified as disordered.
  • Anxiety disorders are psychological disorders characterized by distressing, persistent anxiety or maladaptive behaviors that reduce anxiety.
  • 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 episodes of intense dread.
  • Those with a phobia show an irrational fear and avoidance of a specific object or situation.
  • Two other disorders, obsessive-compulsive disorder and posttraumatic stress disorder, involve anxiety (though they are classified separately from the anxiety disorders).

Question 13.22

What is OCD?

  • Persistent and repetitive thoughts (obsessions) and actions (compulsions) mark obsessive-compulsive disorder (OCD).

Question 13.23

What is PTSD?

  • Symptoms of posttraumatic stress disorder (PTSD) include four or more weeks of haunting memories, nightmares, social withdrawal, jumpy anxiety, and sleep problems following a traumatic event.

Question 13.24

How do learning and biology contribute to the feelings and thoughts found in anxiety disorders, OCD, and PTSD?

  • The learning perspective views anxiety disorders as a product of fear conditioning, stimulus generalization, fearful-behavior reinforcement, and observational learning of others’ fears and cognitions (interpretations, irrational beliefs, and hyperviligance).
  • The biological perspective considers genetic predispositions and the role that fears of life-threatening animals, objects, or situations played in natural selection and evolution.

Substance Use and Addictive Disorders

Question 13.25

What are substance use disorders, and what role do tolerance, withdrawal, and addiction play in these disorders?

  • Those with a substance use disorder may exhibit impaired control, social disruption, risky behavior, and the physical effects of tolerance and withdrawal.
  • Psychoactive drugs alter perceptions and moods. They may produce tolerance—requiring larger doses to achieve the desired effect—and withdrawal—significant discomfort accompanying attempts to quit.
  • Addiction is the compulsive craving of drugs or certain behaviors (such as gambling) despite known harmful consequences.

Question 13.26

How do depressants, such as alcohol, influence neural activity and behavior?

  • Depressants (alcohol, barbiturates, opiates) dampen neural activity and slow body functions.
  • Alcohol disinhibits, increasing the likelihood that we will act on our impulses, whether helpful or harmful.
  • Alcohol slows neural processing, disrupts memory, and shrinks the brain in those with alcohol use disorder (marked by tolerance, withdrawal if use is suspended, and a drive to continue using).
  • User expectations strongly influence alcohol’s behavioral effects.

Question 13.27

How do the major stimulants affect neural activity and behavior?

  • Stimulants (caffeine, nicotine, amphetamines, cocaine, methamphetamine, Ecstasy) excite neural activity, speed up body functions, and lead to heightened energy and mood. All are highly addictive.
  • Nicotine’s effects make smoking a difficult habit to kick, yet the percentage of Americans who smoke has been dramatically decreasing.
  • Cocaine gives users a fast high, followed shortly by a crash. Its risks include cardiovascular stress and suspiciousness.
  • Methamphetamine may permanently reduce dopamine levels.
  • Ecstasy (MDMA), which is also a mild hallucinogen, may damage serotonin-producing neurons and impair physical and cognitive functions.

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Question 13.28

What are the physiological and psychological effects of LSD and marijuana?

  • Hallucinogens (LSD, marijuana) distort perceptions and evoke hallucinations (sensory images in the absence of sensory input), some of which resemble the altered consciousness of near-death experiences.
  • Marijuana’s main ingredient, THC, may trigger feelings of disinhibition, euphoria, relaxation, relief from pain, and intense sensitivity to colors, sounds, tastes, and smells. It may also increase feelings of depression or anxiety, impair motor coordination and reaction time, disrupt memory formation, and damage lung tissue (because of the inhaled smoke).

Question 13.29

What biological, psychological, and social-cultural factors help explain why some people abuse mind-altering drugs?

  • Some people are biologically more vulnerable to drugs, such as alcohol.
  • Psychological factors (such as stress, depression, and hopelessness) and social-cultural influences (peer pressure, cultural values) combine to lead many people to experiment with—and sometimes become addicted to—drugs. Cultural and ethnic groups have differing rates of drug use.

Mood Disorders

Question 13.30

What are the main mood disorders?

  • 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, with little interest in most activities, that is not caused by drugs or a medical condition.
  • A person with the less common condition of bipolar disorder experiences mood swings between depression and mania (hyperactive and wildly optimistic, impulsive feelings and behavior).

Question 13.31

Why do people attempt suicide, and why do some people injure themselves?

  • People with depression are more at risk for suicide than others are, but health status and economic and social frustration are also contributing factors.
  • Forewarnings of suicide may include verbal hints, giving away possessions, self-inflicted injuries, or withdrawal and preoccupation with death. People who talk about suicide should be taken seriously.
  • Nonsuicidal self-injury (NSSI) does not usually lead to suicide but may escalate to suicidal thoughts and acts if untreated. People with NSSI do not tolerate stress well and tend to be self-critical, with poor communication and problem-solving skills.

Question 13.32

How do mood disorders develop? What roles do biology, thinking, and social behavior play?

  • The biological perspective on depression focuses on genetic predispositions and on abnormalities in brain function, including those found in neurotransmitter systems.
  • The social-cognitive perspective views depression as an ongoing cycle of stressful experiences (interpreted through negative beliefs, attributions, and memories) leading to negative moods and actions and fueling new stressful experiences.

Schizophrenia

Question 13.33

What patterns of thinking, perceiving, and feeling characterize schizophrenia?

  • Schizophrenia typically strikes during late adolescence and seems to occur in all cultures.
  • Symptoms are disorganized and delusional thinking, disturbed perceptions, and diminished, inappropriate emotional expression.
  • Delusions are false beliefs; hallucinations are sensory experiences without sensory stimulation.
  • Schizophrenia symptoms may be positive (the presence of inappropriate behaviors) or negative (the absence of appropriate behaviors).
  • In chronic (or process) schizophrenia, the disorder develops gradually and recovery is doubtful. In acute (or reactive) schizophrenia, the onset is sudden, in reaction to stress, and the prospects for recovery are brighter.

Question 13.34

How do chronic and acute schizophrenia differ?

  • In chronic (or process) schizophrenia, the disorder develops gradually and recovery is doubtful. In acute (or reactive) schizophrenia, the onset is sudden, in reaction to stress, and the prospects for recovery are brighter.

Question 13.35

What do we know about the brain chemistry, functions, and structures associated with schizophrenia, and what have we learned about prenatal risk factors?

  • People with schizophrenia have more receptors for dopamine, which may intensify the positive symptoms such as hallucinations and paranoia.
  • Brain scans reveal abnormal activity in the frontal lobes, thalamus, and amygdala.
  • Brain abnormalities associated with schizophrenia include enlarged, fluid-filled cerebral cavities and loss of cerebral cortex.
  • Schizophrenia involves not one isolated brain abnormality but problems with several brain regions and their interconnections.
  • Low weight or oxygen deprivation at birth, famine conditions during the mother’s pregnancy, or a mid-pregnancy virus are possible contributing factors.

Question 13.36

Does research indicate a genetic contribution to schizophrenia?

  • Twin and adoption studies indicate that the predisposition to schizophrenia is inherited.
  • Multiple genes probably interact to produce schizophrenia.
  • No environmental causes invariably produce schizophrenia, but environmental events (such as prenatal viruses or maternal stress) may “turn on” genes for this disorder in those who are predisposed to it.

Other Disorders

Question 13.37

What are the three major eating disorders?

  • In those with eating disorders, psychological factors can overwhelm the body’s tendency to maintain a normal weight.
  • Despite being significantly underweight, people with anorexia nervosa (usually adolescent females) continue to diet and exercise excessively because they view themselves as fat.
  • Those with bulimia nervosa (usually females in their teens and twenties) secretly binge and then compensate with purging, fasting, or excessive exercise.
  • Those with binge-eating disorder binge but do not follow with purging, fasting, and exercise.
  • Cultural pressures, low self-esteem, and negative emotions interact with stressful life experiences and genetics to produce eating disorders.

Question 13.38

What are dissociative disorders, and why are they controversial?

  • Dissociative disorders are conditions in which conscious awareness seems to become separated (to dissociate) from previous memories, thoughts, and feelings.
  • Skeptics note that dissociative identity disorder (formerly 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 protective response to traumatic experience.

Question 13.39

What characteristics are typical of personality disorders in general, and what biological and psychological factors are associated with antisocial personality disorder?

  • Personality disorders are disruptive, inflexible, and enduring behavior patterns that impair social functioning.
  • Antisocial personality disorder is characterized by a lack of conscience and, sometimes, by aggressive and fearless behavior. Genetic predispositions may interact with the environment to produce the altered brain activity associated with this disorder.