5 Steps to a 5 AP Psychology, 2010-2011 Edition (61 page)

Dissociative disorders

Mood disorders

Schizophrenia

Personality disorders

Defining abnormal behavior and showing how it is different from normal behavior is difficult and controversial. A common definition of abnormal behavior is behavior that is personally
disturbing or disabling, or culturally so deviant that others judge it as maladaptive, inappropriate, or unjustifiable. Atypical or deviant means that, statistically, the behavior is rare and has a very low probability of occurring. Legally,
insanity
is an inability to determine right from wrong. This may result in commitment because insane individuals are frequently a threat to themselves or to the community.

Psychiatrist Thomas Szasz sees classification of mental illness as reason to justify political repression, an extreme position that causes us to examine assumptions about what’s normal and what isn’t. David Rosenhan of Stanford University demonstrated that ideas of normality and abnormality are not as clear and accurate as people think. He and colleagues faked the single symptom of hearing voices to gain admission to mental hospitals in five states. They abandoned the symptom once admitted. They found hospitalization to be dehumanizing. Admitted with the diagnosis of paranoid schizophrenia, they were discharged with the diagnosis of paranoid schizophrenia in
remission
(under control).

What causes abnormal behavior? Each perspective of psychology assigns different reasons. The psychoanalytic perspective believes abnormal behavior results from internal conflict in the unconscious stemming from early childhood traumas. The behavioral approach says abnormal behavior consists of maladaptive responses learned through reinforcement of the wrong kinds of behavior. Humanists believe abnormal behavior results from conditions of worth society places upon the individual, which cause a poor self-concept. Since behavior is influenced by how we perceive the world, the cognitive approach sees abnormal behavior as coming from irrational and illogical perceptions and belief systems. Evolutionary psychologists consider mental disorders as harmful evolutionary dysfunctions that occur when evolved psychological mechanisms do not perform their naturally selected functions effectively. Finally, the biological approach explains abnormal behavior as the result of neurochemical and/or hormonal imbalances, genetic predispositions, structural damage to brain parts, or faulty processing of information by the brain.

Abnormal behavior is often talked about as mental illness. The medical model looks at abnormal behavior as a disease, using terms such as
psychopathology
, which is the study of the origin, development, and manifestations of mental or behavioral disorders;
etiology
, which is the apparent cause and development of an illness; and
prognosis
, which forecasts the probable course of an illness. The American Psychiatric Association used a medical model for the
Diagnostic and Statistical Manual
(DSM-IV) that classifies psychological disorders by their symptoms. This guidebook for mental health professionals lists diagnostic criteria for 17 major categories of mental disorders, subdivided into about 400 disorders. DSM-IV enables mental health professionals to communicate information about individuals who suffer from abnormalities, and helps them decide how to treat an individual. DSM-IV is the 1994 revision (DSM-IV-TR, 2000) of DSM-III-R published in 1987. Early versions (DSM-I and II) were unreliable and invalid, but beginning with DSM-III, diagnostic categories have been clearly listed, assumptions about suspected causes of disorders have been eliminated, numbers of disorders have been increased, and diagnoses are given on five axes (dimensions).
Axis I: Clinical Syndromes
contains all of the major disorders including anxiety, depression, schizophrenia, substance abuse, and organic mental disorders.
Axis II: Personality Disorders and Mental Retardation
contains disorders such as obsessive-compulsive and mild retardation that could be overlooked when focus is on Axis I.
Individuals can have diagnoses on both Axes I and II. The other axes deal with general medical conditions, psychosocial and environmental problems, and global assessment of functioning. Reliability of diagnoses has improved significantly and validity is considered to have been improved. Most North American third-party providers (medical insurance companies) require diagnoses from DSM-IV for payment of mental health benefits. Criticisms of the use of DSM-IV include the thought that “labeling is disabling,” whereby diagnostic labels are applied to the whole person (e.g., John’s a schizophrenic) rather than used to mean the individual is suffering from a particular disorder; and that categorization results in attributing characteristics to the individual that he/she doesn’t possess, or in missing something important about the individual.

Anxiety is the primary symptom, or the primary cause of other symptoms, for all anxiety disorders. Anxiety is a feeling of impending doom or disaster from a specific or unknown source that is characterized by mood symptoms of tension, agitation, and apprehension; bodily symptoms of sweating, muscular tension, and increased heart rate and blood pressure; as well as cognitive symptoms of worry, rumination, and distractibility. Anxiety disorders include panic disorder, generalized anxiety disorder, phobias, obsessive-compulsive disorder, and post-traumatic stress disorder.

•
Panic disorder
is the diagnosis when an individual experiences repeated attacks of intense anxiety along with severe chest pain, tightness of muscles, choking, sweating, or other acute symptoms. These symptoms can last anywhere from a few minutes to a couple of hours. Panic attacks have no apparent trigger and can happen at any time. Since these are statistically rare, having perhaps three of these in a 6-month period of time would be cause for alarm.

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Generalized anxiety disorder
is similar to a panic disorder. Symptoms must occur for at least 6 months and include chronic anxiety not associated with any specific situation or object. The person frequently has trouble sleeping, is hypervigilant and tense, has difficulty concentrating, and can be irritable much of the time.

Panic disorder has acute symptoms short in duration, whereas generalized anxiety disorder has less-intense symptoms for a longer period of time.

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Phobias
are intense, irrational fear responses to specific stimuli. Nearly 5% of the population suffers from some mild form of phobic disorder. A fear turns into a phobia when it provokes a compelling, irrational desire to avoid a dreaded situation or object, disrupting the person’s daily life. Common phobias include:

agoraphobia
—fear of being out in public
acrophobia
—fear of heights
claustrophobia
—fear of enclosed spaces
zoophobia
—fear of animals (such as snakes, mice, rats, spiders, dogs, and cats)

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Obsessive-compulsive disorder
(OCD) is a compound disorder of thought and behavior.
Obsessions
are persistent, intrusive, and unwanted thoughts that an individual cannot get out of his/her mind. Obsessions are different from worries; they generally involve a unique topic (such as dirt or contamination, death, or aggression), are often repugnant, and are seen as uncontrollable. If a person were frequently bothered by thoughts of wanting to harm others, this would be called an obsession. Obsessions are
often accompanied by
compulsions
, ritualistic behaviors performed repeatedly, which the person does to reduce the tension created by the obsession. Common compulsions include handwashing, counting, checking, and touching.

•
Post-traumatic stress disorder
(PTSD) is a result of some trauma experienced (natural disaster, war, violent crime) by the victim. Victims reexperience the traumatic event in nightmares about the event, or flashbacks in which the individual relives the event and behaves as if he/she is experiencing it at that moment. Victims may also experience reduced involvement with the external world, and general arousal characterized by hyperalertness, guilt, and difficulty concentrating.

The behavioral perspective says that anxiety responses are acquired through classical conditioning and maintained through operant conditioning. The cognitive perspective attributes anxiety disorders to misinterpretation of harmless situations as threatening, focusing excessive attention on perceived threats, and selectively recalling threatening information. The biological perspective attributes anxiety disorders at least partly to neurotransmitter imbalances. Generalized anxiety disorder, often treated with benzodiazepines (Valium, Xanax), is associated with too little availability of the inhibitory neurotransmitter GABA in some neural circuits, while obsessive-compulsive disorder and panic disorder, often treated with antidepressants (Prozac, Paxil, Zoloft), are associated with low levels of serotonin. The evolutionary perspective attributes the presence of anxiety to natural selection for enhanced vigilance that operates ineffectively in the absence of real threats.